MEDICARE: DR. JEFFREY M SCHWARTZ MD

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	208D00000X	General Practice Physician	ME50872	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME50872	OTHER	FL	LICENSE NUMBER

General Provider Information

NPI Number	:	1215041074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY M SCHWARTZ MD

Provider Business Mailing Address
First Line	:	4729 US HIGHWAY 98 S
Second Line	:	SUITE 105
City	:	LAKELAND
State	:	FL
Zip	:	33812-4323
Country	:	US
Telephone Number	:	863-619-9800
Fax Number	:	863-619-9840

Provider Business Practice Location Address
First Line	:	4729 US HIGHWAY 98 S
Second Line	:	SUITE 105
City	:	LAKELAND
State	:	FL
Zip	:	33812-4323
Country	:	US
Telephone Number	:	863-619-9800
Fax Number	:	863-619-9840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	03/07/2023

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