Healthcare Provider Details

I. General information

NPI: 1245511591
Provider Name (Legal Business Name): MELISSA ANN SCOTT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA ANN CRABB PA-C

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4098 LIBRA DR
ORLANDO FL
32816-5722
US

IV. Provider business mailing address

235 N WESTMONTE DR
ALTAMONTE SPRINGS FL
32714-3345
US

V. Phone/Fax

Practice location:
  • Phone: 407-823-2701
  • Fax:
Mailing address:
  • Phone: 407-389-5300
  • Fax: 407-389-5363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9106125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: