Provider Demographics
NPI:1043582331
Name:SCOTT E. FARBER, DDS.,P.A
Entity type:Organization
Organization Name:SCOTT E. FARBER, DDS.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-282-3304
Mailing Address - Street 1:5150 CURRY FORD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8744
Mailing Address - Country:US
Mailing Address - Phone:407-282-3304
Mailing Address - Fax:407-380-5486
Practice Address - Street 1:5150 CURRY FORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-8744
Practice Address - Country:US
Practice Address - Phone:407-282-3304
Practice Address - Fax:407-380-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0010034204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT85347OtherMEDICARE PROVIDER # 60586 FLORIDA