Provider Demographics
NPI:1215283783
Name:SCHOONOVER, DENISE MICHELLE (ARNP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MICHELLE
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:MICHELLE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2612
Practice Address - Street 1:21297 OLEAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-6704
Practice Address - Country:US
Practice Address - Phone:855-979-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1215283783363L00000X
FL9237475363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP1014190OtherFREEDOM HEALTH
FL008357000Medicaid
FLY0LF7OtherBCBS FL
FLP953145OtherOPTIMUM
FLP01298314OtherRAILROAD MCR
FLY0LF7OtherBCBS FL