Healthcare Provider Details

I. General information

NPI: 1407728652
Provider Name (Legal Business Name): DK SCOTT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 BLACKJACK OAK ST
OCOEE FL
34761-5605
US

IV. Provider business mailing address

2236 BLACKJACK OAK ST
OCOEE FL
34761-5605
US

V. Phone/Fax

Practice location:
  • Phone: 689-304-7900
  • Fax: 800-507-8671
Mailing address:
  • Phone: 689-304-7900
  • Fax: 800-507-8671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH K SCOTT
Title or Position: MANAGING MEMBER
Credential: APRN
Phone: 689-304-7900