Provider Demographics
NPI:1265618870
Name:SCHMITT, VICTORIA (DNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:MARIA VICTORIA
Other - Middle Name:D
Other - Last Name:FAUSTINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP
Mailing Address - Street 1:15712 IBISRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3893
Mailing Address - Country:US
Mailing Address - Phone:630-267-2627
Mailing Address - Fax:630-503-6600
Practice Address - Street 1:500 S FLORIDA AVE STE 330
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5240
Practice Address - Country:US
Practice Address - Phone:800-457-4573
Practice Address - Fax:800-443-6422
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11012241363LP0808X
IL277.000560363LP0808X
IL209006796363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid
IL$$$$$$$$$001Medicaid