MEDICARE: DR. JASON LEWIS SCHWARTZ O.D.

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	OPC3170	FL

General Provider Information

NPI Number	:	1982600078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON LEWIS SCHWARTZ O.D.

Provider Business Mailing Address
First Line	:	1378 SE 17TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-1708
Country	:	US
Telephone Number	:	954-467-6227
Fax Number	:	954-779-7354

Provider Business Practice Location Address
First Line	:	1378 SE 17TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-1708
Country	:	US
Telephone Number	:	954-467-6227
Fax Number	:	954-779-7354

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/18/2007

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