Doctor Name: | SCOTT A GROAT |
NPI Number: | 1700812385 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | PO 1786 |
Business Practice Address: | 151 S Mary Esther Blvd Ste 510 Mary Esther, FL - 325691972 |
Business Phone Number: | 8502431255 |
Business Fax Number: | 8506645578 |
Mailing Address: | 151 S Mary Esther Blvd, Suite 510 MARY ESTHER |
State: | FL |
Postal Code: | 325691972 |
Phone Number: | 8502431255 |
Fax Number: | 8506645578 |
NPI Enumeration Date: | 06/24/2006 |
NPI Last Update Date: | 12/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | PO 1786 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |