Provider Demographics
NPI:1578837522
Name:SCOTT COMITER, M.D., P.A.
Entity Type:Organization
Organization Name:SCOTT COMITER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:COMITER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-784-7204
Mailing Address - Street 1:50 E SAMPLE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3552
Mailing Address - Country:US
Mailing Address - Phone:954-784-7204
Mailing Address - Fax:954-784-7205
Practice Address - Street 1:50 E SAMPLE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3552
Practice Address - Country:US
Practice Address - Phone:954-784-7204
Practice Address - Fax:954-784-7205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61855208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF40850Medicare UPIN