Provider Demographics
NPI:1285817254
Name:SCOTT B ELSBREE MD PA
Entity Type:Organization
Organization Name:SCOTT B ELSBREE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:ELSBREE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-379-8481
Mailing Address - Street 1:5831 BEE RIDGE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5088
Mailing Address - Country:US
Mailing Address - Phone:941-379-8481
Mailing Address - Fax:941-379-3781
Practice Address - Street 1:5831 BEE RIDGE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5088
Practice Address - Country:US
Practice Address - Phone:941-379-8481
Practice Address - Fax:941-379-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDG9618OtherRAIL ROAD MEDICARE
FL=========OtherEIN
FLDG9618OtherRAIL ROAD MEDICARE