Healthcare Provider Details

I. General information

NPI: 1770577090
Provider Name (Legal Business Name): BRETT M SCOTCH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27406 CASHFORD CIR
WESLEY CHAPEL FL
33544-8199
US

IV. Provider business mailing address

27406 CASHFORD CIR
WESLEY CHAPEL FL
33544-8199
US

V. Phone/Fax

Practice location:
  • Phone: 813-994-8900
  • Fax: 561-725-8788
Mailing address:
  • Phone: 813-994-8900
  • Fax: 561-725-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberOS9765
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberOS9765
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number5101014778
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License NumberOS9765
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberOS9765
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberOS9765
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: