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General NPI Number Information
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NPI Number | 1285799403
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Entity Type | Organization
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Legal Business Name | SCOT D. MACHLUS, PH.D., P.A.
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13939 LAKESHORE BLVD
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City | HUDSON
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State | FL
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Zip | 34667-7116
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Country | US
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Telephone | 727-862-7171
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Fax | 727-372-5035
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Provider Business Mailing Address
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Address Line | 13939 LAKESHORE BLVD
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City | HUDSON
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State | FL
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Zip | 34667-7116
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Country | US
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Telephone | 727-862-7171
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Fax | 727-372-5035
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOT D. MACHLUS
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Credential | PH.D.
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Telephone | 727-862-7171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY4321
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License Number State | FL
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