Provider Demographics
NPI:1063535334
Name:SCHMIDT, JEFFREY DOUGLAS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DOUGLAS
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4823 GARDENS RUN
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-7299
Mailing Address - Country:US
Mailing Address - Phone:941-721-8024
Mailing Address - Fax:
Practice Address - Street 1:6242 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-3065
Practice Address - Country:US
Practice Address - Phone:941-723-6726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA200009183500000X
FLPS37971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist