Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME89196 | FL |
NPI | 1336138254 |
---|---|
Provider Name | Dr. David L Scott |
First Address | Hudson, FL 34674-5515 |
Second Address | Hudson, FL 34667-1158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 30/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
48533 | BLUE SHIELD OF FLORIDA (01) | FL |
BS8965216 | DEA (01) | |
H81445 | (02) | |
ME89196 | MEDICAL LICENSE (01) | FL |