Healthcare Provider Details

I. General information

NPI: 1942946744
Provider Name (Legal Business Name): SANDRA SCHAINKIN SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7263 ATLANTIC AVE
DELRAY BEACH FL
33446-1305
US

IV. Provider business mailing address

7263 ATLANTIC AVE
DELRAY BEACH FL
33446-1305
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-2020
  • Fax: 561-496-3846
Mailing address:
  • Phone: 561-496-2020
  • Fax: 561-496-3846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberDO1531
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: