Provider Demographics
NPI:1104878594
Name:SCHWARTZWALD, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SCHWARTZWALD
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 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 195
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-939-0700
Practice Address - Fax:561-483-8706
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50481208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3335290OtherCIGNA
FL4292309OtherAETNA
FL2807OtherDIMENSION
FLP971581OtherOPTIMUM
FL071806OtherAVMED
FL970464OtherWELLCARE
FLP00862OtherFREEDOM
FLP01604160OtherRR MEDICARE
FL03801OtherBCBS
FL1017242OtherWELLCARE
FLD20840Medicare UPIN
FLP01604160OtherRR MEDICARE
FL1017242OtherWELLCARE