Provider Demographics
NPI:1063936755
Name:SCHMIDT, KATLYN (DC)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATLYN
Other - Middle Name:
Other - Last Name:GORTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1645 PALM BEACH LAKES BLVD STE 1200
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1645 PALM BEACH LAKES BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2214
Practice Address - Country:US
Practice Address - Phone:786-303-6862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL663785Medicaid
1063936755OtherINSURANCE