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NPI Code Detail

MEDICARE: RAVEN E SCOTT

MEDICARE: RAVEN E 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
1253Z00000XIn Home Supportive Care Agency232846FL

General Provider Information

NPI Number : 1225382260
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAVEN E SCOTT
Provider Business Mailing Address
First Line : 1800 PEMBROOK DR STE 300
Second Line :
City : ORLANDO
State : FL
Zip : 32810-6378
Country : US
Telephone Number : 407-274-3881
Fax Number :
Provider Business Practice Location Address
First Line : 1800 PEMBROOK DR STE 300
Second Line :
City : ORLANDO
State : FL
Zip : 32810-6378
Country : US
Telephone Number : 407-274-3881
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RAVEN EVETTE SCOTT
Credential :
Telephone Number : 407-274-3881
Provider Enumeration Date : 10/29/2012
Last Update Date : 10/30/2012

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Directions to “RAVEN E SCOTT ” Practice Location

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