MEDICARE: LEONARD SCHLOFMAN OD. PA.

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	152W00000X	Optometrist	OPC 1499	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	:	1861730392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEONARD SCHLOFMAN OD. PA.

Provider Business Mailing Address
First Line	:	PO BOX 190
Second Line	:	1105 S. WALNUT
City	:	STARKE
State	:	FL
Zip	:	32091-4413
Country	:	US
Telephone Number	:	904-964-8076
Fax Number	:	904-964-8107

Provider Business Practice Location Address
First Line	:	1105 S. WALNUT
Second Line	:
City	:	STARKE
State	:	FL
Zip	:	32091-4413
Country	:	US
Telephone Number	:	904-964-8076
Fax Number	:	904-964-8107

Authorized Official
Title or Position	:	OWNER/PRES
Name	:	DR. ARTHUR LEONARD SCHLOFMAN
Credential	:	OD
Telephone Number	:	904-964-8076

Provider Enumeration Date	:	01/17/2013
Last Update Date	:	02/22/2013

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