MEDICARE: MS. HARRIET LUCILE 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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1972827152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HARRIET LUCILE SCOTT

Provider Business Mailing Address
First Line	:	5118 N 56TH ST
Second Line	:	SUITE 242
City	:	TAMPA
State	:	FL
Zip	:	33610-5416
Country	:	US
Telephone Number	:	813-977-7677
Fax Number	:	813-977-5017

Provider Business Practice Location Address
First Line	:	5118 N 56TH ST
Second Line	:	SUITE 242
City	:	TAMPA
State	:	FL
Zip	:	33610-5416
Country	:	US
Telephone Number	:	813-977-7677
Fax Number	:	813-977-5017

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

Provider Enumeration Date	:	03/17/2010
Last Update Date	:	03/17/2010

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