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General NPI Number Information
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NPI Number | 1851437164
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Entity Type | Individual
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Provider Name | CLARENCE SCOTT M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 1061 MEDICAL CENTER DR SUITE 101
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City | ORANGE CITY
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State | FL
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Zip | 32763-8200
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Country | US
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Telephone | 386-917-5547
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Fax | 386-917-5569
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Provider Business Mailing Address
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Address Line | 931 VIHLEN RD
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City | SANFORD
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State | FL
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Zip | 32771-7736
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Country | US
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Telephone | 407-491-5230
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Fax | 407-324-4694
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME59756
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License Number State | FL
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