Individual
CARL SCHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2441 SURFSIDE BLVD, SUITE 200, CAPE CORAL, FL 33914-3821
(239) 541-7500
(239) 541-7501
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS6923
FL
207Q00000X
Family Medicine Physician
Primary
OS6923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221012
AMERIGROUP
FL
05
—
378797400
—
FL
01
—
5304033
AETNA
FL
01
—
57143
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/20/2006
Last updated
08/18/2017
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