Individual
SCOTT A EARNHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1810 S. PINELLAS AVE, SUITE L, TARPON SPRINGS, FL 34689
(727) 755-3483
Mailing address
1810 S. PINELLAS AVE, SUITE L, TARPON SPRINGS, FL 34689
(727) 755-3483
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
59846
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59846
SCUBA INSTRUCTOR
FL
01
—
7274125196
STORE NUMBER
FL
Enumeration date
05/16/2018
Last updated
05/16/2018
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