MEDICARE: DR. SCOTT C HARCOURT PHD

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	103T00000X	Psychologist	PY11983	FL

General Provider Information

NPI Number	:	1538407986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT C HARCOURT PHD

Provider Business Mailing Address
First Line	:	5200 BABCOCK ST NE STE 304
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4648
Country	:	US
Telephone Number	:	321-209-2525
Fax Number	:	321-914-0010

Provider Business Practice Location Address
First Line	:	5200 BABCOCK ST NE STE 304
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4648
Country	:	US
Telephone Number	:	321-209-2525
Fax Number	:	321-914-0010

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

Provider Enumeration Date	:	01/18/2013
Last Update Date	:	07/23/2024

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