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General NPI Number Information
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NPI Number | 1689620809
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Entity Type | Individual
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Provider Name | KEVIN S SCHROEDER MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 2020 59TH STREET WEST BLAKE MEDICAL CENTER
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City | BRADENTON
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State | FL
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Zip | 34209
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Country | US
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Telephone | 941-792-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 804 40TH STREET WEST C/O STOUTAMYER STRATOS SCHROEDER WHALEY RIZZO & ASSO MD
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City | BRADENTON
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State | FL
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Zip | 34205
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Country | US
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Telephone | 941-749-5464
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Fax | 941-747-1815
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME0056356
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License Number State | FL
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