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General NPI Number Information
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NPI Number | 1053801001
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Entity Type | Individual
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Provider Name | IMARA-SAFI OLU SCOTT MD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 1632 RIGGINS RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5316
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Country | US
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Telephone | 850-877-4134
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Fax | 850-942-4112
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Provider Business Mailing Address
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Address Line | PO BOX 13834
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City | TALLAHASSEE
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State | FL
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Zip | 32317-3834
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Country | US
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Telephone | 850-205-6232
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Fax | 855-975-0615
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 318278
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME170552
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License Number State | FL
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