MEDICARE: MARC S SCHNEIDER MDPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	ME0050478	FL

General Provider Information

NPI Number	:	1053583492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARC S SCHNEIDER MDPA

Provider Business Mailing Address
First Line	:	12751 S CLEVELAND AVE
Second Line	:	SUITE 102
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7732
Country	:	US
Telephone Number	:	239-277-9999
Fax Number	:	239-277-3998

Provider Business Practice Location Address
First Line	:	12751 S CLEVELAND AVE
Second Line	:	SUITE 102
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7732
Country	:	US
Telephone Number	:	239-277-9999
Fax Number	:	239-277-3998

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARC STEVEN SCHNEIDER
Credential	:	MD
Telephone Number	:	239-277-9999

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	03/26/2008

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