Provider Demographics
NPI:1487675385
Name:GILES, SCOTT (PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:GILES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 W CENTRAL PKWY
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2436
Mailing Address - Country:US
Mailing Address - Phone:407-767-8554
Mailing Address - Fax:407-767-9121
Practice Address - Street 1:450 W CENTRAL PKWY
Practice Address - Street 2:SUITE 2000
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2436
Practice Address - Country:US
Practice Address - Phone:407-767-8554
Practice Address - Fax:407-767-9121
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP49638Medicare UPIN
FLE6852ZMedicare ID - Type UnspecifiedMEDICARE