Provider Demographics
NPI:1447510276
Name:SCHMIDT, MARK (DVM)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18011 OLD BAYSHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33917-5825
Mailing Address - Country:US
Mailing Address - Phone:515-778-3055
Mailing Address - Fax:239-731-0235
Practice Address - Street 1:18011 OLD BAYSHORE RD
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33917-5825
Practice Address - Country:US
Practice Address - Phone:515-778-3055
Practice Address - Fax:239-731-0235
Is Sole Proprietor?:No
Enumeration Date:2012-05-27
Last Update Date:2012-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11220174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian