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General NPI Number Information
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NPI Number | 1861463069
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Entity Type | Individual
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Provider Name | JEROME GERARD SCAVONE MD
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1600 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3019
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Country | US
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Telephone | 863-680-7000
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Fax | 866-264-8519
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Provider Business Mailing Address
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Address Line | 3829 EXETER LN
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City | LAKELAND
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State | FL
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Zip | 33810-2422
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Country | US
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Telephone | 407-797-6284
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME70033
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME70033
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License Number State | FL
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