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General NPI Number Information
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NPI Number | 1699147108
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Entity Type | Organization
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Legal Business Name | JEREMY SCHMITT
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Dates
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Enumeration Date | 10/23/2015
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 6808 DALI AVE # D201
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City | LAND O LAKES
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State | FL
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Zip | 34637-7849
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Country | US
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Telephone | 813-420-7204
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Fax |
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Provider Business Mailing Address
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Address Line | 6808 DALI AVE # D201
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City | LAND O LAKES
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State | FL
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Zip | 34637-7849
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Country | US
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Telephone | 813-420-7204
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | JEREMY SCHMITT
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Credential |
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Telephone | 813-420-7204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | PTA22858
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License Number State | FL
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