Provider Demographics
NPI:1316947948
Name:SCHOENBERG, ERIK DARRELL (MD)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:DARRELL
Last Name:SCHOENBERG
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 1:200 N MANGOUSTINE AVE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1017
Mailing Address - Country:US
Mailing Address - Phone:407-833-7415
Mailing Address - Fax:407-833-7416
Practice Address - Street 1:200 N MANGOUSTINE AVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1017
Practice Address - Country:US
Practice Address - Phone:407-833-7415
Practice Address - Fax:407-833-7416
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD22591207Y00000X
FLME128748207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287955Medicaid
ORR112831Medicare PIN
OR287955Medicaid