Provider Demographics
NPI:1861408718
Name:SCHLEIMER, RONALD (PAC)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:SCHLEIMER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11451 48TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33708-2709
Mailing Address - Country:US
Mailing Address - Phone:727-393-1467
Mailing Address - Fax:727-507-3618
Practice Address - Street 1:3231 MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695
Practice Address - Country:US
Practice Address - Phone:727-725-6100
Practice Address - Fax:727-725-6118
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S60821Medicare UPIN