Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DN13008 | FL |
NPI | 1568508729 |
---|---|
Provider Name | Dr. Patricia Ann Scott |
First Address | Port Charlotte, FL 33952-8159 |
Second Address | Port Charlotte, FL 33952-8159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U32617 | (02) | FL |