Individual
BUELAH E SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
13940 N US HIGHWAY 441, SUITE 702, LADY LAKE, FL 32159-8908
(352) 751-1095
Mailing address
PO BOX 490210, LEESBURG, FL 34749-0210
(352) 751-1095
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT5010
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z063X
BLUE SHIELD PROV NUMBER
FL
Enumeration date
04/11/2006
Last updated
06/15/2010
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