Provider Demographics
NPI:1851414668
Name:BRAY, SCOTT (AP,LAC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:BRAY
Suffix:
Gender:M
Credentials:AP,LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10967 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4457
Mailing Address - Country:US
Mailing Address - Phone:407-658-1341
Mailing Address - Fax:407-704-1576
Practice Address - Street 1:10967 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 109
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4457
Practice Address - Country:US
Practice Address - Phone:407-658-1341
Practice Address - Fax:407-704-1576
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAP789171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist