Provider Demographics
NPI:1396714549
Name:SCOTT, JEFFERY E (PHARMD, CPH CGP)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:E
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHARMD, CPH CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 WATERVIEW PL
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8330
Mailing Address - Country:US
Mailing Address - Phone:321-239-6826
Mailing Address - Fax:
Practice Address - Street 1:6251 CHANCELLOR DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5501
Practice Address - Country:US
Practice Address - Phone:877-985-6337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37719183500000X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric