Provider Demographics
NPI:1225216302
Name:SCOTT, JOHN S (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:S
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 W INDIANTOWN RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7546
Mailing Address - Country:US
Mailing Address - Phone:561-745-1002
Mailing Address - Fax:561-745-7880
Practice Address - Street 1:654 W INDIANTOWN RD
Practice Address - Street 2:SUITE 107
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7546
Practice Address - Country:US
Practice Address - Phone:561-745-1002
Practice Address - Fax:561-745-7880
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAW784ZMedicare UPIN
FLAW784ZMedicare PIN