Provider Demographics
NPI:1336178433
Name:EADER, SCOTT ALAN (DO, MPH)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:EADER
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2606 CENTENNIAL PL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0572
Mailing Address - Country:US
Mailing Address - Phone:850-205-0189
Mailing Address - Fax:850-329-2903
Practice Address - Street 1:2621 CATTLEMEN RD STE 204
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6212
Practice Address - Country:US
Practice Address - Phone:850-205-0189
Practice Address - Fax:850-329-2903
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY041732084P0800X
IN02002346A2084P0800X, 208D00000X
FLOS150572084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN