Provider Demographics
NPI:1356307979
Name:MCDONALD, WILLIAM SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:W
Other - Middle Name:SCOTT
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8740 N KENDALL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2209
Mailing Address - Country:US
Mailing Address - Phone:305-381-8900
Mailing Address - Fax:305-379-6777
Practice Address - Street 1:8740 N KENDALL DR STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2209
Practice Address - Country:US
Practice Address - Phone:305-381-8900
Practice Address - Fax:305-379-6777
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2020-05-28
Deactivation Date:2007-03-21
Deactivation Code:
Reactivation Date:2007-03-22
Provider Licenses
StateLicense IDTaxonomies
FLME75972208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43556WMedicare PIN
FL43556WMedicare PIN
FL011030300Medicaid
D04168Medicare UPIN
FL43556UMedicare PIN