Provider Demographics
NPI:1730187782
Name:RAY, SCOTT L (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:L
Last Name:RAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:2350 SUNSET POINT RD
Practice Address - Street 2:SUITE C
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1443
Practice Address - Country:US
Practice Address - Phone:727-797-3155
Practice Address - Fax:727-797-4301
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2019-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOSOOO4600207QG0300X
FLOS4600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069515700Medicaid
FL069515700Medicaid
FLD60675Medicare UPIN