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General NPI Number Information
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NPI Number | 1689692576
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Entity Type | Individual
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Provider Name | SCOTT R FLORELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 4488 HANALEI PLANTATION RD
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City | PRINCEVILLE
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State | HI
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Zip | 96722-5462
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Country | US
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Telephone | 808-320-7300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3208
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City | SALT LAKE CITY
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State | UT
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Zip | 84110-3208
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Country | US
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Telephone | 801-587-6340
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Fax | 801-587-6346
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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 | 2761741205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 2761741205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 276174-1205
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 276174-1205
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License Number State | UT
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Taxonomy #5
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | MD-21397
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License Number State | HI
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