Provider Demographics
NPI:1275725681
Name:JOSEPH-SCOTT, GINA LESLEY-ANN
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:LESLEY-ANN
Last Name:JOSEPH-SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:GINA
Other - Middle Name:LESLEY-ANN
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:832 W CENTRAL BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-1809
Mailing Address - Country:US
Mailing Address - Phone:407-836-2604
Mailing Address - Fax:407-836-2522
Practice Address - Street 1:832 W CENTRAL BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1809
Practice Address - Country:US
Practice Address - Phone:407-836-2604
Practice Address - Fax:407-836-2522
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator