MEDICARE: MRS. JENNIFER L SCHROEDER L.D.O

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	156FX1800X	Optician	5142	FL

General Provider Information

NPI Number	:	1669495875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER L SCHROEDER L.D.O

Provider Business Mailing Address
First Line	:	3594 BROADWAY
Second Line	:	SUITE H
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8016
Country	:	US
Telephone Number	:	239-275-7320
Fax Number	:	239-275-7721

Provider Business Practice Location Address
First Line	:	3594 BROADWAY
Second Line	:	SUITE H
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8016
Country	:	US
Telephone Number	:	239-275-7320
Fax Number	:	239-275-7721

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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