Provider Demographics
NPI:1275376451
Name:SCHUETZ, JOHN MICHAEL
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:SCHUETZ
Suffix:
Gender:M
Credentials:
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 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-468-0150
Mailing Address - Fax:239-343-4056
Practice Address - Street 1:23450 VIA COCONUT PT FL 2
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:34135-1877
Practice Address - Country:US
Practice Address - Phone:394-680-1502
Practice Address - Fax:239-343-4056
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11040702363LF0000X
FLRN9531134163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL127910400Medicaid