Provider Demographics
NPI:1013238070
Name:SHURPIN, SCOTT (CPT LMT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:SHURPIN
Suffix:
Gender:M
Credentials:CPT LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SE 15TH TER
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4464
Mailing Address - Country:US
Mailing Address - Phone:954-591-0552
Mailing Address - Fax:
Practice Address - Street 1:201 SE 15TH TER
Practice Address - Street 2:SUITE 201
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4464
Practice Address - Country:US
Practice Address - Phone:954-591-0552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 18217172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA 18217OtherI HAVE MY LICENSE NUMBER.