Provider Demographics
NPI:1417088360
Name:CARROL-SCOTT, TINA S (MD)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:S
Last Name:CARROL-SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:TINA
Other - Middle Name:S
Other - Last Name:CARROL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6701 SW 58TH PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3699
Mailing Address - Country:US
Mailing Address - Phone:305-662-5988
Mailing Address - Fax:305-662-5589
Practice Address - Street 1:6701 SW 58TH PL
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3699
Practice Address - Country:US
Practice Address - Phone:305-662-5988
Practice Address - Fax:305-662-5589
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67630208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics