Organization
SCOTT P. BRODY, M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT PHILIP BRODY M.D. (OWNER)
(904) 260-9808
Entity
Organization
Contact information
Practice address
11798 SAN JOSE BLVD, SUITE 1, JACKSONVILLE, FL 32223-1836
(904) 260-9808
(904) 260-2770
Mailing address
11798 SAN JOSE BLVD, SUITE 1, JACKSONVILLE, FL 32223-1836
(904) 260-9808
(904) 260-2770
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME69231
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27848
BLUE CROSS AND BLUE SHIELD
FL
05
—
378841500
—
FL
01
—
P00395604
RAILROAD MEDICARE
FL
Enumeration date
05/04/2010
Last updated
08/04/2010
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