Provider Demographics
NPI:1912043217
Name:SCOTT, MELANIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15310
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-1310
Mailing Address - Country:US
Mailing Address - Phone:941-749-1734
Mailing Address - Fax:941-749-1736
Practice Address - Street 1:5211 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3742
Practice Address - Country:US
Practice Address - Phone:941-749-1734
Practice Address - Fax:941-749-1736
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7666ZMedicare ID - Type UnspecifiedINDIVIDUAL NUMBER
FLII204AMedicare PIN