Basic Information
| Provider Information | |||||||||
| NPI: | 1184007965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHWEIBISH | ||||||||
| FirstName: | DAVID | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1678 MAEVE CIR | ||||||||
| Address2: | |||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329047348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3217774774 | ||||||||
| FaxNumber: | 9042121351 | ||||||||
| Practice Location | |||||||||
| Address1: | 2020 HIGHWAY A1A STE 101 | ||||||||
| Address2: | |||||||||
| City: | INDIAN HARBOUR BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3217774774 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2015 | ||||||||
| LastUpdateDate: | 11/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | PO4034 | FL | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 213E00000X | PO4034 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.