Provider Demographics
NPI:1942946744
Name:SCOTT, SANDRA SCHAINKIN
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:SCHAINKIN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7263 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1305
Mailing Address - Country:US
Mailing Address - Phone:561-496-2020
Mailing Address - Fax:561-496-3846
Practice Address - Street 1:7263 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1305
Practice Address - Country:US
Practice Address - Phone:561-496-2020
Practice Address - Fax:561-496-3846
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO1531156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty