Healthcare Provider Details

I. General information

NPI: 1548454317
Provider Name (Legal Business Name): SCOTT MEISEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 PALM BEACH LAKES BLVD STE 101
WEST PALM BEACH FL
33409-6501
US

IV. Provider business mailing address

900 VILLAGE SQUARE XING STE 290
PALM BEACH GARDENS FL
33410-4552
US

V. Phone/Fax

Practice location:
  • Phone: 561-296-7710
  • Fax: 561-296-7709
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberOS11189
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS11189
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: