MEDICARE: VINETTE SCOTT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1083956270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINETTE SCOTT

Provider Business Mailing Address
First Line	:	1717 HIALEAH ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-6023
Country	:	US
Telephone Number	:	407-748-5572
Fax Number	:	407-412-6007

Provider Business Practice Location Address
First Line	:	1717 HIALEAH ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-6023
Country	:	US
Telephone Number	:	407-748-5572
Fax Number	:	407-412-6007

Authorized Official
Title or Position	:	OWNER/ADMINSTRATOR
Name	:	MISS VINNETTE CLAIRE SCOTT
Credential	:	CNA
Telephone Number	:	407-748-5572

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	03/26/2013

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