Provider Demographics
NPI:1043272842
Name:SCHROEDER, PATRICIA A (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:SCHROEDER
Suffix:
Gender:F
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:PO BOX 25317
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5317
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:1375 ROBERTS DR STE 206
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3209
Practice Address - Country:US
Practice Address - Phone:904-247-1456
Practice Address - Fax:904-247-2281
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63694207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372685100Medicaid
FL372685100Medicaid
FLF57337Medicare UPIN