Organization
SILVERSAGE PHYSICIAN SERVICES OF FLORIDA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH L SCOTT D.O. (PRESIDENT)
(423) 815-1605
Entity
Organization
Contact information
Practice address
175 VILLA NUEVA AVE NE, PALM BAY, FL 32907-2595
(321) 952-1818
Mailing address
PO BOX 22784, CHATTANOOGA, TN 37422-2784
(423) 815-1600
(423) 763-1118
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
08/15/2016
Last updated
01/23/2017
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