Provider Demographics
NPI:1942235270
Name:SCRANTON, STEPHEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:SCRANTON
Suffix:
Gender:M
Credentials:MD
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 766
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34697-0766
Mailing Address - Country:US
Mailing Address - Phone:727-738-8416
Mailing Address - Fax:727-736-8812
Practice Address - Street 1:3253 N MCMULLEN BOOTH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2043
Practice Address - Country:US
Practice Address - Phone:727-725-6174
Practice Address - Fax:727-799-1521
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37761207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110243960OtherRAILROAD MEDICARE
FLP00221159OtherRAILROAD MEDICARE
FL30450OtherBCBS
FL110243960OtherRAILROAD MEDICARE
FLP00221159OtherRAILROAD MEDICARE