Healthcare Provider Details

I. General information

NPI: 1083718563
Provider Name (Legal Business Name): GILLIAN CATHERINE SCOTT M.S.N., A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8175 NW 12TH ST SUITE 306
DORAL FL
33126-1828
US

IV. Provider business mailing address

8175 NW 12TH ST SUITE 306
DORAL FL
33126-1828
US

V. Phone/Fax

Practice location:
  • Phone: 786-845-0164
  • Fax: 305-470-5846
Mailing address:
  • Phone: 786-845-0173
  • Fax: 305-470-5846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1101792
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1101792
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: