Healthcare Provider Details

I. General information

NPI: 1871565705
Provider Name (Legal Business Name): SCOTT PURRONE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 DON WICKHAM DR
CLERMONT FL
34711-1979
US

IV. Provider business mailing address

10923 PRIEBE RD
CLERMONT FL
34711-8601
US

V. Phone/Fax

Practice location:
  • Phone: 352-241-7180
  • Fax:
Mailing address:
  • Phone: 321-221-1432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: