Healthcare Provider Details

I. General information

NPI: 1700463049
Provider Name (Legal Business Name): SCAPLED XPERTS & CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 03/24/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 E FRIERSON AVE
TAMPA FL
33610-5124
US

IV. Provider business mailing address

3501 E FRIERSON AVE
TAMPA FL
33610-5124
US

V. Phone/Fax

Practice location:
  • Phone: 813-324-0180
  • Fax:
Mailing address:
  • Phone: 813-324-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name: CHANTINA WILSON
Title or Position: OWNER
Credential:
Phone: 813-324-0180