Provider Demographics
NPI:1346394491
Name:AHRNDT, SCOTT B (PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:B
Last Name:AHRNDT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8745 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-7524
Mailing Address - Country:US
Mailing Address - Phone:772-217-5362
Mailing Address - Fax:772-228-8481
Practice Address - Street 1:8745 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-7524
Practice Address - Country:US
Practice Address - Phone:772-217-5362
Practice Address - Fax:772-228-8481
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9114789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP10780Medicare UPIN
WAAB16797Medicare ID - Type Unspecified