Provider Demographics
NPI:1700173036
Name:LEKANE, SCOTT (PTA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:LEKANE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27604 KIRKWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-8724
Mailing Address - Country:US
Mailing Address - Phone:813-624-2536
Mailing Address - Fax:
Practice Address - Street 1:4914 CREEKSIDE DR STE B
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-4017
Practice Address - Country:US
Practice Address - Phone:813-455-9621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19020171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor