Provider Demographics
NPI:1245518489
Name:SCHREINER, CHARLES LEO IV (RN, ACNP-BC)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:LEO
Last Name:SCHREINER
Suffix:IV
Gender:M
Credentials:RN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 W SAN PEDRO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-6925
Mailing Address - Country:US
Mailing Address - Phone:281-220-7500
Mailing Address - Fax:
Practice Address - Street 1:1 TAMPA GENERAL CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-844-8051
Practice Address - Fax:813-844-5753
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX757973363LA2100X
FLARNP9467571363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285472101Medicaid
TX853N26OtherBCBS
TX285472101Medicaid