Individual
DR. SCOTT R HANNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
720 W OAK ST STE 309, KISSIMMEE, FL 34741-4910
(407) 518-4982
(407) 518-1748
Mailing address
720 W OAK ST, SUITE 380, KISSIMMEE, FL 34741-4910
(407) 518-4982
(407) 518-1748
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
OS8740
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17027
BCBS
FL
05
—
264703600
—
FL
Enumeration date
07/25/2006
Last updated
06/01/2020
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