Provider Demographics
NPI:1063792653
Name:SCHAMAUN, JONATHAN FREDRICK (ARNP)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:FREDRICK
Last Name:SCHAMAUN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18344
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-8344
Mailing Address - Country:US
Mailing Address - Phone:813-874-5500
Mailing Address - Fax:813-874-5500
Practice Address - Street 1:38135 MARKET SQ
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7505
Practice Address - Country:US
Practice Address - Phone:352-567-0188
Practice Address - Fax:813-355-5101
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9233664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9233664OtherSTATE OF FLORIDA
FL012050500Medicaid
FLFK619YMedicare UPIN
FLARNP9233664OtherSTATE OF FLORIDA