Healthcare Provider Details

I. General information

NPI: 1053683425
Provider Name (Legal Business Name): RAYMOND WESTON SCOTT CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 UNDERWOOD ST
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

52 UNDERWOOD ST
ORLANDO FL
32806-1110
US

V. Phone/Fax

Practice location:
  • Phone: 407-527-7429
  • Fax: 321-843-2196
Mailing address:
  • Phone: 407-527-7429
  • Fax: 321-843-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9267000
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: