=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669664587
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHULZ EYE CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2007
-----------------------------------------------------
Last Update Date | 02/28/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4107 LITTLE RD
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34655-1722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-376-3131
-----------------------------------------------------
Fax | 727-376-3009
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4107 LITTLE RD
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34655-1722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-376-3131
-----------------------------------------------------
Fax | 727-376-3009
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST/PRESIDENT
-----------------------------------------------------
Name | DR. ROBERT MICHAEL SCHULZ
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 727-376-3131
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OPC1366
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------