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Individual

LARISSA ZAULYANOV SCANLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13550 JOG ROAD, S. D201, DELRAY BEACH, FL 33446-3809
(561) 637-2516
(561) 637-4657
Mailing address
13550 JOG ROAD, S. D201, DELRAY BEACH, FL 33446-3809
(561) 637-2516
(561) 637-4657

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME95300
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME95300
LICENSE
FL
Enumeration date
06/18/2006
Last updated
06/03/2015
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