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NPI Code Detail

MEDICARE: DR. LOREN SCOTT CARLSON DO

MEDICARE:  DR. LOREN SCOTT CARLSON  DO
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
1207Q00000XFamily Medicine PhysicianOS8011FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902829419
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOREN SCOTT CARLSON DO
Provider Business Mailing Address
First Line : 2415 UNIVERSITY PKWY
Second Line : SUITE 111
City : SARASOTA
State : FL
Zip : 34243-2809
Country : US
Telephone Number : 941-351-2020
Fax Number : 941-360-1362
Provider Business Practice Location Address
First Line : 2415 UNIVERSITY PKWY
Second Line : SUITE 111
City : SARASOTA
State : FL
Zip : 34243-2809
Country : US
Telephone Number : 941-351-2020
Fax Number : 941-360-1362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 08/22/2014

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Directions to “ DR. LOREN SCOTT CARLSON DO” Practice Location

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