Healthcare Provider Details

I. General information

NPI: 1922096106
Provider Name (Legal Business Name): SCOTT R MCGLYNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 11TH CT STE 203B
VERO BEACH FL
32960-5012
US

IV. Provider business mailing address

3450 11TH CT STE 206B
VERO BEACH FL
32960-5012
US

V. Phone/Fax

Practice location:
  • Phone: 772-778-8687
  • Fax:
Mailing address:
  • Phone: 772-778-8687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME178031
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: