MEDICARE: MS. REVONDOLYN L SCOTT RD

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	133N00000X	Nutritionist
2	133V00000X	Registered Dietitian	ND4121	FL
3	133N00000X	Nutritionist	865489

General Provider Information

NPI Number	:	1578505780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REVONDOLYN L SCOTT RD

Provider Business Mailing Address
First Line	:	8135 W LYNWOOD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-1144
Country	:	US
Telephone Number	:	602-330-2502
Fax Number	:

Provider Business Practice Location Address
First Line	:	8135 W LYNWOOD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043
Country	:	US
Telephone Number	:	602-330-2502
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	08/14/2018

Similar Medicare Providers

1760334551 — MADISON NICOLE CALABRETTA
Practice Location Address:

7815 W RIVERSIDE AVE
PHOENIX, AZ
85043-1774

Practice Phone: 714-715-2960
Practice Fax:

1205788098 — JOVANNI VILLARREAL
Practice Location Address:

6425 W MCKINLEY ST
PHOENIX, AZ
85043-2412

Practice Phone: 602-500-7610
Practice Fax:

1578415360 — DANIELLE MARIE MUNOZ
Practice Location Address:

7815 W RIVERSIDE AVE
PHOENIX, AZ
85043-1774

Practice Phone: 219-321-4904
Practice Fax:

1841289188 — DR. PETER PHUOC NGUYEN DMD
Practice Location Address:

7435 W LOWER BUCKEYE RD
PHOENIX, AZ
85043-7636

Practice Phone: 623-907-9334
Practice Fax:

1083669212 — MATTHEW LAWRENCE PRESS OTR/L
Practice Location Address:

5641 W WOOD ST
PHOENIX, AZ
85043-6324

Practice Phone: 602-283-4556
Practice Fax:

1710927462 — CENTERWELL PHARMACY, INC.
Practice Location Address:

4302 W BUCKEYE RD
PHOENIX, AZ
85043-4904

Practice Phone: 800-379-0092
Practice Fax: 800-379-7617

Directions to “ MS. REVONDOLYN L SCOTT RD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.