Provider Demographics
NPI:1538177936
Name:SCHWARTZ, MARC FRANKLIN (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:FRANKLIN
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S TROTTERS DR
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5735
Mailing Address - Country:US
Mailing Address - Phone:407-740-0331
Mailing Address - Fax:407-537-2747
Practice Address - Street 1:331 N MAITLAND AVE
Practice Address - Street 2:STE B2
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4762
Practice Address - Country:US
Practice Address - Phone:407-740-0331
Practice Address - Fax:407-539-2747
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047068174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72948Medicare ID - Type Unspecified
FLE19735Medicare UPIN