Provider Demographics
NPI:1902092604
Name:PILLER, SCOTT C (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:C
Last Name:PILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 CRESTVIEW CIR NW
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-2126
Mailing Address - Country:US
Mailing Address - Phone:941-629-8444
Mailing Address - Fax:941-629-9513
Practice Address - Street 1:795 CRESTVIEW CIR NW
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-2126
Practice Address - Country:US
Practice Address - Phone:941-629-8444
Practice Address - Fax:941-629-9513
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0186UOtherBCBS GROUP #
NC890186UOtherMEDICAID GRP#
NC2453940OtherMEDICARE GROUP#
NC5909244Medicaid
NC086A4OtherBCBS
NC2456045Medicare PIN
NC5909244Medicaid