Provider Demographics
NPI:1134466725
Name:SPRINGSTEAD, SCOTT-MICHAEL ROSS (RN)
Entity Type:Individual
Prefix:
First Name:SCOTT-MICHAEL
Middle Name:ROSS
Last Name:SPRINGSTEAD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11271 66TH TER
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-6243
Mailing Address - Country:US
Mailing Address - Phone:727-518-5486
Mailing Address - Fax:
Practice Address - Street 1:11271 66TH TER
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-6243
Practice Address - Country:US
Practice Address - Phone:727-518-5486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN8303624163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse