=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407166408
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RICHARD G. SCHWARTZ, M.D.,P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2010
-----------------------------------------------------
Last Update Date | 04/12/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1500 N DIXIE HWY SUITE 304
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33401-2712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-833-4022
-----------------------------------------------------
Fax | 561-833-4180
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1500 NORTH DIXIE HIGHWAY SUITE 304
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33401-2717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-833-4022
-----------------------------------------------------
Fax | 561-833-4180
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. TERRY J. SNYDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-833-4022
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | ME0034767
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------