Provider Demographics
NPI:1821008582
Name:JUDD, SCOTT D (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:JUDD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13550 SW 120TH ST
Mailing Address - Street 2:STE 502
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7505
Mailing Address - Country:US
Mailing Address - Phone:813-632-8861
Mailing Address - Fax:813-977-1742
Practice Address - Street 1:13701 BRUCE B DOWNS BLVD
Practice Address - Street 2:STE 106
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4647
Practice Address - Country:US
Practice Address - Phone:813-632-8861
Practice Address - Fax:813-977-1742
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2019-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME90662207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052602901Medicaid