Provider Demographics
NPI:1790900694
Name:SCAMARD, DAVID F (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:SCAMARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 GRAND CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-6797
Mailing Address - Country:US
Mailing Address - Phone:813-279-7038
Mailing Address - Fax:813-279-7039
Practice Address - Street 1:2225 GRAND CYPRESS DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559
Practice Address - Country:US
Practice Address - Phone:813-279-7038
Practice Address - Fax:813-279-7039
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3394152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP2068Medicare PIN
6477030001Medicare NSC