Provider Demographics
NPI:1063583086
Name:SCHMIDT, MICHAEL P (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:SCHMIDT
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 1:2223 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1264
Mailing Address - Country:US
Mailing Address - Phone:954-360-7769
Mailing Address - Fax:
Practice Address - Street 1:2223 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1264
Practice Address - Country:US
Practice Address - Phone:954-360-7769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057364207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100030300Medicaid
14228OtherVISTA
228675OtherAMERIGROUP
2461ASOPOtherNHP
5998615OtherGHI
13811OtherWELLCARE
988484BOtherTOTAL HEALTH CHOICE
10444OtherHEALTH OPTIONS
112110OtherHUMANA
2511292012OtherCIGNA
650352916OtherUNITED HEALTH CARE
10444OtherBCBS
015763OtherAETNA
101675OtherAVMED
10444OtherBCBS