MEDICARE: DR. SCOTT DAVID STREISAND MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	ME82964	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9929882	OTHER	FL	CIGNA
2	P971569	OTHER	FL	OPTIMUM
3	1237593	OTHER	FL	WELLCARE
4	296043	OTHER	FL	AVMED
5	P1035806	OTHER	FL	FREEDOM
6	01964	OTHER	FL	BCBS
7	7863323	OTHER	FL	AETNA
8	10693	OTHER	FL	DIMENSION
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386634103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT DAVID STREISAND MD

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: PAYER CONTRACTING & RELATIONS DEPT.
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	7421 N UNIVERSITY DR
Second Line	:	SUITE 106
City	:	TAMARAC
State	:	FL
Zip	:	33321-2952
Country	:	US
Telephone Number	:	954-722-0150
Fax Number	:	954-722-0188

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	08/18/2016

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Directions to “ DR. SCOTT DAVID STREISAND MD” Practice Location

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