Provider Demographics
NPI:1386634103
Name:STREISAND, SCOTT DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DAVID
Last Name:STREISAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:SUITE 106
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2952
Practice Address - Country:US
Practice Address - Phone:954-722-0150
Practice Address - Fax:954-722-0188
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2016-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME82964208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9929882OtherCIGNA
FLP971569OtherOPTIMUM
FL1237593OtherWELLCARE
FL296043OtherAVMED
FLP1035806OtherFREEDOM
FL01964OtherBCBS
FL7863323OtherAETNA
FL10693OtherDIMENSION
FL01964AMedicare PIN
FL01964OtherBCBS
FL1237593OtherWELLCARE