Provider Demographics
NPI:1295983575
Name:SCHAFFER, HEATHER R (OD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:R
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 BRINY AVE
Mailing Address - Street 2:APT. 2509
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-5610
Mailing Address - Country:US
Mailing Address - Phone:785-213-5715
Mailing Address - Fax:
Practice Address - Street 1:143 N POWERLINE RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-8037
Practice Address - Country:US
Practice Address - Phone:954-429-9600
Practice Address - Fax:954-429-9956
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4381152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001227700Medicaid