Provider Demographics
NPI:1043545866
Name:MCLAURIN, SCOTT CAMERON (PA-C)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:CAMERON
Last Name:MCLAURIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 VONDERBURG DR
Mailing Address - Street 2:SUITE 311 WEST
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5964
Mailing Address - Country:US
Mailing Address - Phone:813-654-2445
Mailing Address - Fax:813-654-9885
Practice Address - Street 1:500 VONDERBURG DR
Practice Address - Street 2:SUITE 311 WEST
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5964
Practice Address - Country:US
Practice Address - Phone:813-654-2445
Practice Address - Fax:813-654-9885
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105141363AM0700X
CA65506363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical