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General NPI Number Information
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NPI Number | 1710167267
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Entity Type | Individual
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Provider Name | MR. SCOTT W SITTERSON
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Gender | Male
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 21301 S TAMIAMI TRL STE 130
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City | ESTERO
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State | FL
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Zip | 33928-2943
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Country | US
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Telephone | 239-947-5616
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Fax | 239-946-9606
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Provider Business Mailing Address
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Address Line | 501 KEENAN AVE
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City | FORT MYERS
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State | FL
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Zip | 33919-3108
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Country | US
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Telephone | 239-994-0966
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Fax | 239-437-6846
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | FL 9125
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License Number State | FL
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