Provider Demographics
NPI:1891117370
Name:SCOTT, ALEX
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8457 NARCOOSSEE RD
Mailing Address - Street 2:APT. #11102
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-5635
Mailing Address - Country:US
Mailing Address - Phone:407-591-2934
Mailing Address - Fax:
Practice Address - Street 1:8457 NARCOOSSEE RD
Practice Address - Street 2:APT. #11102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-5635
Practice Address - Country:US
Practice Address - Phone:407-591-2934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health