MEDICARE: THOMAS JOSEPH SCHULZ JR. BCBA

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	103K00000X	Behavior Analyst	1-19-37680	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558813923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS JOSEPH SCHULZ JR. BCBA

Provider Business Mailing Address
First Line	:	300 INTERNATIONAL PKWY
Second Line	:	SUITE 200
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5028
Country	:	US
Telephone Number	:	866-610-0580
Fax Number	:	407-588-6294

Provider Business Practice Location Address
First Line	:	12725 RACE TRACK RD # 5
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1314
Country	:	US
Telephone Number	:	813-467-7190
Fax Number	:	813-422-6431

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

Provider Enumeration Date	:	11/01/2016
Last Update Date	:	12/18/2019

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