Provider Demographics
NPI:1255310215
Name:SITTLER, SCOTT Y (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:Y
Last Name:SITTLER
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 1593
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32802-1593
Mailing Address - Country:US
Mailing Address - Phone:407-963-3789
Mailing Address - Fax:
Practice Address - Street 1:8150 CHANCELLOR DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7691
Practice Address - Country:US
Practice Address - Phone:407-587-4243
Practice Address - Fax:407-251-5053
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58810207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11532VMedicare PIN
FL11532XMedicare PIN
FL11532YMedicare PIN
FLE68772Medicare UPIN