MEDICARE: MS. SUSAN TRAINOR SCOVELL ARNP

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	363LF0000X	Family Nurse Practitioner	ARNP2800382	FL

General Provider Information

NPI Number	:	1801186317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN TRAINOR SCOVELL ARNP

Provider Business Mailing Address
First Line	:	720 N BAY ST
Second Line	:	SUITE 11
City	:	EUSTIS
State	:	FL
Zip	:	32726-2964
Country	:	US
Telephone Number	:	352-589-9661
Fax Number	:	352-589-5983

Provider Business Practice Location Address
First Line	:	720 N BAY ST
Second Line	:	SUITE 11
City	:	EUSTIS
State	:	FL
Zip	:	32726-2964
Country	:	US
Telephone Number	:	352-589-9661
Fax Number	:	352-589-5983

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

Provider Enumeration Date	:	04/18/2011
Last Update Date	:	05/24/2026

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