Healthcare Provider Details

I. General information

NPI: 1447715123
Provider Name (Legal Business Name): TIERRA VERONA SCOTT CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2019
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E SILVER SPRINGS BLVD STE 127
OCALA FL
34470-6833
US

IV. Provider business mailing address

1515 E SILVER SPRINGS BLVD STE 127
OCALA FL
34470-6833
US

V. Phone/Fax

Practice location:
  • Phone: 352-361-1100
  • Fax:
Mailing address:
  • Phone: 352-355-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number30212442
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number312172
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: