MEDICARE: MICHAELA G SCOTT M.D.

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	207RH0003X	Hematology & Oncology Physician	ME0025287	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10D0276491	OTHER	FL	CLIA
2	CN9289	OTHER	FL	RR GROUP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1017703	OTHER	FL	NCPDP
5	G8850	OTHER	FL	BCBS GROUP

General Provider Information

NPI Number	:	1649272899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAELA G SCOTT M.D.

Provider Business Mailing Address
First Line	:	1926 OCEAN DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-2112
Country	:	US
Telephone Number	:	772-231-3033
Fax Number	:

Provider Business Practice Location Address
First Line	:	1926 OCEAN DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-2112
Country	:	US
Telephone Number	:	772-231-3033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	11/06/2018

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