# SCOTT P. BRODY, M.D., PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568780302
- **Authorized official:** DR. SCOTT PHILIP BRODY M.D. (OWNER)
- **Authorized official phone:** (904) 260-9808

## Contact information

- **Practice address:** 11798 SAN JOSE BLVD, SUITE 1, JACKSONVILLE, FL 32223-1836
- **Practice address phone:** (904) 260-9808
- **Practice address fax:** (904) 260-2770
- **Mailing address:** 11798 SAN JOSE BLVD, SUITE 1, JACKSONVILLE, FL 32223-1836
- **Mailing address phone:** (904) 260-9808
- **Mailing address fax:** (904) 260-2770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME69231 | FL | Yes |

## Other

- **Enumeration date:** 05/04/2010
- **Last updated:** 08/04/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 27848 | BLUE CROSS AND BLUE SHIELD | FL |
| 05 | — | 378841500 | — | FL |
| 01 | — | P00395604 | RAILROAD MEDICARE | FL |