Provider Demographics
NPI:1114540200
Name:SCHUMACHER, LEIFERIK DYLAN (MD)
Entity type:Individual
Prefix:
First Name:LEIFERIK
Middle Name:DYLAN
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LEIF-ERIK
Other - Middle Name:
Other - Last Name:SCHUMACHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:736 13TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-4418
Mailing Address - Country:US
Mailing Address - Phone:858-525-2354
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:858-525-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30527390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program