Healthcare Provider Details
I. General information
NPI: 1285817254
Provider Name (Legal Business Name): SCOTT B ELSBREE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2007
Last Update Date: 05/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5831 BEE RIDGE RD SUITE 210
SARASOTA FL
34233-5088
US
IV. Provider business mailing address
5831 BEE RIDGE RD SUITE 210
SARASOTA FL
34233-5088
US
V. Phone/Fax
- Phone: 941-379-8481
- Fax: 941-379-3781
- Phone: 941-379-8481
- Fax: 941-379-3781
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SCOTT
B
ELSBREE
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 941-379-8481