Healthcare Provider Details

I. General information

NPI: 1700030178
Provider Name (Legal Business Name): SCOTT M SCHLAUDER M.D. M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 PLEASANT HILL RD SUITE 101
KISSIMMEE FL
34759-3400
US

IV. Provider business mailing address

4545 PLEASANT HILL RD SUITE 101
KISSIMMEE FL
34759-3400
US

V. Phone/Fax

Practice location:
  • Phone: 888-578-3188
  • Fax: 407-264-8955
Mailing address:
  • Phone: 888-578-3188
  • Fax: 407-264-8955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberME106835
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: