=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326322876
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANTHONY T SCHIUMA MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2011
-----------------------------------------------------
Last Update Date | 10/03/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2830 E OAKLAND PARK BLVD
-----------------------------------------------------
City | FT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33306-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-561-4300
-----------------------------------------------------
Fax | 954-561-0809
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2830 E OAKLAND PARK BLVD
-----------------------------------------------------
City | FT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33306-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-561-4300
-----------------------------------------------------
Fax | 954-561-0809
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. PHYLLIS AMBROSINO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-561-4300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | ME30835
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------