=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487672820
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MITCHELL ALAN SCHUSTER MD PA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2006
-----------------------------------------------------
Last Update Date | 03/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 951 NW 13TH ST SUITE 3E
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33486
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-368-5558
-----------------------------------------------------
Fax | 561-368-7907
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 951 NW 13TH ST SUITE 3E
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33486
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-368-5558
-----------------------------------------------------
Fax | 561-368-7907
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME79854
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------