Provider Demographics
NPI:1588878557
Name:SCHULZE, MICHELLE JAN
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JAN
Last Name:SCHULZE
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:JAN
Other - Last Name:SCHULZE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AP
Mailing Address - Street 1:P.O. BOX 844
Mailing Address - Street 2:
Mailing Address - City:ARCHER
Mailing Address - State:FL
Mailing Address - Zip Code:32618
Mailing Address - Country:US
Mailing Address - Phone:407-701-7168
Mailing Address - Fax:
Practice Address - Street 1:802B NW 23RD AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3534
Practice Address - Country:US
Practice Address - Phone:407-701-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP #15992081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine