Individual
SCOTT BRUCE RAVEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1055 SAXON BLVD, ORANGE CITY, FL 32763-8468
(386) 943-4522
Mailing address
PO BOX 9430, DAYTONA BEACH, FL 32120-9430
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS5559
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061707500
—
FL
01
—
80276
BLUE CROSS OF FLORIDA
FL
Enumeration date
05/26/2006
Last updated
08/03/2009
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