Organization
SCOTT J LOESSIN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT J LOESSIN MD (PHYSICIAN)
(386) 258-3223
Entity
Organization
Contact information
Practice address
311 N CLYDE MORRIS BLVD, SUITE 510, DAYTONA BEACH, FL 32114-2781
(386) 258-3223
(386) 252-8237
Mailing address
311 N CLYDE MORRIS BLVD, 510, DAYTONA BEACH, FL 32114-2781
(386) 258-3223
(386) 252-8237
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME0067948
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26863
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
09/21/2006
Last updated
09/25/2008
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