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General NPI Number Information
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NPI Number | 1770535809
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Entity Type | Organization
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Legal Business Name | STOUTAMYER STRATOS SCHROEDER WHALEY & RIZZO MDS PA
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 2020 59TH ST 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 ST WEST
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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 | PRESIDENT
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Name | KEVIN S SCHROEDER
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Credential | MD
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Telephone | 941-749-5464
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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 |
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License Number State |
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