Provider Demographics
NPI:1952350902
Name:WEEKS, SCOTT ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ROBERT
Last Name:WEEKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 BUNKER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2805
Mailing Address - Country:US
Mailing Address - Phone:813-789-5823
Mailing Address - Fax:
Practice Address - Street 1:5504 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-4270
Practice Address - Country:US
Practice Address - Phone:813-948-5400
Practice Address - Fax:813-907-2173
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8388207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261498700Medicaid
FL01834Medicare ID - Type Unspecified
FL261498700Medicaid