Provider Demographics
NPI:1316349954
Name:SCHAEFER, KATHARINE BARBARA (ARNP)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:BARBARA
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 LUCIEN WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7003
Mailing Address - Country:US
Mailing Address - Phone:407-875-0028
Mailing Address - Fax:
Practice Address - Street 1:2201 LUCIEN WAY STE 100
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7003
Practice Address - Country:US
Practice Address - Phone:407-875-0028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9307926363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9307926OtherMEDICAL LICENSE
FL013522300Medicaid
FLARNP9307926OtherMEDICAL LICENSE