Healthcare Provider Details

I. General information

NPI: 1649517392
Provider Name (Legal Business Name): SARAH J SCOTT RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 01/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 W COPELAND DR 2ND FLOOR
ORLANDO FL
32806-2002
US

IV. Provider business mailing address

89 W COPELAND DR 2ND FLOOR
ORLANDO FL
32806-2002
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-3303
  • Fax: 321-841-3305
Mailing address:
  • Phone: 321-841-3303
  • Fax: 321-841-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN9223550
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: