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Individual

SCOTT BOLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
19369 US HIGHWAY 19 N APT 416, CLEARWATER, FL 33764-3317
(502) 292-7575
Mailing address
19369 US HIGHWAY 19 N APT 416, CLEARWATER, FL 33764-3317

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9113109
FL
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
PA9113109
FL

Other

Enumeration date
04/07/2020
Last updated
03/15/2022
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