Provider Demographics
NPI:1225144199
Name:SCOTT W RICE MD PA
Entity Type:Organization
Organization Name:SCOTT W RICE MD PA
Other - Org Name:OCEANCITY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-998-9178
Mailing Address - Street 1:8550 TOUCHTON RD APT 217
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1185
Mailing Address - Country:US
Mailing Address - Phone:904-998-9178
Mailing Address - Fax:904-642-8298
Practice Address - Street 1:8550 TOUCHTON RD APT 217
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1185
Practice Address - Country:US
Practice Address - Phone:904-998-9178
Practice Address - Fax:904-642-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69340207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266002400Medicaid
FLK7534Medicare ID - Type UnspecifiedOCEANCITY HEALTHCARE
FLE36503Medicare UPIN