Provider Demographics
NPI:1164421186
Name:FRENCH, SCOTT ALLEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALLEN
Last Name:FRENCH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 STATE ROAD 674
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-3515
Mailing Address - Country:US
Mailing Address - Phone:813-633-8489
Mailing Address - Fax:
Practice Address - Street 1:5121 STATE ROAD 674
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-3515
Practice Address - Country:US
Practice Address - Phone:813-633-8489
Practice Address - Fax:813-633-2669
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100944363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290588400Medicaid
FL290588400Medicaid