MEDICARE: DR. SCOTT A MESSNER PH.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	103G00000X	Clinical Neuropsychologist	PY6162	FL
2	103TA0700X	Adult Development & Aging Psychologist	PY6162	FL
3	103TC0700X	Clinical Psychologist	PY6162	FL

General Provider Information

NPI Number	:	1750427969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT A MESSNER PH.D.

Provider Business Mailing Address
First Line	:	922 S D ST
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-4732
Country	:	US
Telephone Number	:	561-434-5565
Fax Number	:

Provider Business Practice Location Address
First Line	:	1844 FAIRVIEW VILLAS DR
Second Line	:	#4
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6663
Country	:	US
Telephone Number	:	561-434-5565
Fax Number	:

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	05/19/2014

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