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General NPI Number Information
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NPI Number | 1679093579
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Entity Type | Individual
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Provider Name | JESSICA SAMANTHA SCHWARTZ
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Gender | Female
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9970 CENTRAL PARK BLVD N STE 400
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City | BOCA RATON
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State | FL
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Zip | 33428-2236
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Country | US
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Telephone | 561-487-7931
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Fax | 561-487-1204
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Provider Business Mailing Address
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Address Line | 1440 SW 28TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2808
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Country | US
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Telephone | 954-204-7165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | UO4919
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License Number State | FL
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