Provider Demographics
NPI:1871565705
Name:PURRONE, SCOTT (PA-C)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:PURRONE
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:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34760-0903
Mailing Address - Country:US
Mailing Address - Phone:321-221-1432
Mailing Address - Fax:321-221-1438
Practice Address - Street 1:200 AVENUE F NE
Practice Address - Street 2:WINTER HAVEN HOSPITAL
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4131
Practice Address - Country:US
Practice Address - Phone:863-293-1121
Practice Address - Fax:407-654-8260
Is Sole Proprietor?:No
Enumeration Date:2006-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS68268Medicare UPIN