Provider Demographics
NPI:1427016203
Name:SCOTT, JEFFREY M (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 NW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1015
Mailing Address - Country:US
Mailing Address - Phone:305-243-6372
Mailing Address - Fax:
Practice Address - Street 1:1600 NW 10TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1015
Practice Address - Country:US
Practice Address - Phone:305-243-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8572207RC0200X, 207RP1001X
KYTP401207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00279584OtherRAILROAD MEDICARE
FL267474200Medicaid
FL71891OtherBCBS
FLH92364Medicare UPIN
FL71891UMedicare ID - Type Unspecified
FL71891SMedicare PIN
FL267474200Medicaid
FL71891TMedicare PIN