Provider Demographics
NPI:1972030385
Name:SCOTT, IAN (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 TOWN PLAZA CT
Mailing Address - Street 2:STE 1020
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6231
Mailing Address - Country:US
Mailing Address - Phone:407-901-7704
Mailing Address - Fax:407-288-8582
Practice Address - Street 1:7560 RED BUG LAKE RD STE 1080
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6601
Practice Address - Country:US
Practice Address - Phone:407-901-7704
Practice Address - Fax:407-288-8582
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor