Provider Demographics
NPI:1669742185
Name:SCOTT, ALLISON L (PHARMD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12749 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3806
Mailing Address - Country:US
Mailing Address - Phone:239-939-2142
Mailing Address - Fax:239-939-7893
Practice Address - Street 1:12749 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3806
Practice Address - Country:US
Practice Address - Phone:239-939-2142
Practice Address - Fax:239-939-7893
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist