Provider Demographics
NPI:1255496139
Name:SCIRE, PHILIP V JR (PA C)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:V
Last Name:SCIRE
Suffix:JR
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2685 SW 32ND PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7862
Mailing Address - Country:US
Mailing Address - Phone:352-732-9643
Mailing Address - Fax:352-732-2243
Practice Address - Street 1:2685 SW 32ND PL
Practice Address - Street 2:SUITE 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7862
Practice Address - Country:US
Practice Address - Phone:352-732-9643
Practice Address - Fax:352-732-2243
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAX0000749363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S59825Medicare UPIN