Healthcare Provider Details

I. General information

NPI: 1376642231
Provider Name (Legal Business Name): SCOTT D NORRIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 MILITARY TRL STE 200
JUPITER FL
33458-7830
US

IV. Provider business mailing address

4215 BURNS RD STE 200
PALM BEACH GARDENS FL
33410-4625
US

V. Phone/Fax

Practice location:
  • Phone: 591-694-7776
  • Fax: 561-694-3099
Mailing address:
  • Phone: 591-694-7776
  • Fax: 561-694-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS8259
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberOS8259
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: