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General NPI Number Information
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NPI Number | 1679438857
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Entity Type | Organization
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Legal Business Name | SCOTT EYE & VISION LLC
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1187 JOHN SIMS PKWY E
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City | NICEVILLE
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State | FL
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Zip | 32578-2752
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Country | US
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Telephone | 619-321-7521
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Fax |
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Provider Business Mailing Address
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Address Line | 200 PAGE BACON RD APT 2415
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City | MARY ESTHER
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State | FL
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Zip | 32569-1763
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Country | US
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Telephone | 619-321-7521
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DUSTIN SCOTT
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Credential | OD
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Telephone | 619-321-7521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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