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NPI Code Detail

MEDICARE: ASHLEY SCONZO PA

MEDICARE: ASHLEY SCONZO PA
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
1363AS0400XSurgical Physician AssistantPA9108227FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811392616
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY SCONZO PA
Provider Business Mailing Address
First Line : 1995 E OAKLAND PARK BLVD STE 310
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33306-1138
Country : US
Telephone Number : 954-791-6146
Fax Number : 954-337-2733
Provider Business Practice Location Address
First Line : 1995 E OAKLAND PARK BLVD STE 310
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33306-1138
Country : US
Telephone Number : 954-791-6146
Fax Number : 954-337-2733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2014
Last Update Date : 06/07/2021

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1417321894 — MR. TREVOR ALLEN KOLSKI PA-C
Practice Location Address:
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33306-1138
Practice Phone: 954-791-6146
Practice Fax:

Directions to “ ASHLEY SCONZO PA” Practice Location

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