Provider Demographics
NPI:1396519401
Name:SCOTT, ROTECHIA
Entity type:Individual
Prefix:
First Name:ROTECHIA
Middle Name:
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 1:3500 UNIVERSITY BLVD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2302
Mailing Address - Country:US
Mailing Address - Phone:904-219-1884
Mailing Address - Fax:
Practice Address - Street 1:3500 UNIVERSITY BLVD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2302
Practice Address - Country:US
Practice Address - Phone:904-219-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No291U00000XLaboratoriesClinical Medical Laboratory
No376J00000XNursing Service Related ProvidersHomemaker