Provider Demographics
NPI:1043276124
Name:SCHIFF, THEODORE ANDREW (MD)
Entity type:Individual
Prefix:
First Name:THEODORE
Middle Name:ANDREW
Last Name:SCHIFF
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 1:600 VILLAGE SQUARE XING
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4542
Mailing Address - Country:US
Mailing Address - Phone:561-694-9493
Mailing Address - Fax:561-694-9064
Practice Address - Street 1:600 VILLAGE SQUARE XING
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4542
Practice Address - Country:US
Practice Address - Phone:561-694-9493
Practice Address - Fax:561-694-9064
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME065381207N00000X, 207ND0101X, 207ND0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43350OtherBCBC FL PROVIDER #
FL43350OtherBCBC FL PROVIDER #
FLE0339YMedicare ID - Type Unspecified
FLE0339ZMedicare ID - Type Unspecified
FLE0339WMedicare ID - Type Unspecified
FLF59991Medicare UPIN
FLE0339VMedicare ID - Type Unspecified