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Individual

DR. SCOTT DUDAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9325 GLADES RD, SUITE 101, BOCA RATON, FL 33434-3907
(561) 482-8887
(561) 451-1768
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
138590
MT
208800000X
Urology Physician
Primary
64623
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1026039
CAREPLUS
FL
01
225484
AVMED
FL
01
28385
WELLCARE
FL
01
45095
BCBS
FL
01
5439647
AETNA
FL
01
P01601030
RR MEDICARE
FL
01
P1010627
FREEDOM
FL
01
P970896
OPTIMUM
FL
Enumeration date
06/07/2006
Last updated
03/20/2024
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