Healthcare Provider Details

I. General information

NPI: 1356307979
Provider Name (Legal Business Name): WILLIAM SCOTT MCDONALD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: W SCOTT MCDONALD M.D.

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date: 03/21/2007
Reactivation Date: 03/22/2007

III. Provider practice location address

8740 N KENDALL DR STE 101
MIAMI FL
33176-2209
US

IV. Provider business mailing address

8740 N KENDALL DR STE 101
MIAMI FL
33176-2209
US

V. Phone/Fax

Practice location:
  • Phone: 305-381-8900
  • Fax: 305-379-6777
Mailing address:
  • Phone: 305-381-8900
  • Fax: 305-379-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME75972
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME75972
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: