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Individual

DR. EDWARD DENNIS SCANLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
426 W BRANDON BLVD, BRANDON, FL 33511-5002
(813) 681-4444
(813) 661-8763
Mailing address
426 W BRANDON BLVD, BRANDON, FL 33511-5002
(813) 681-4444
(813) 661-8763

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0048898
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114182235
GROUP NPI
FL
01
1861475196
NPI
FL
01
GW208Z
MEDICARE PTAN #
FL
Enumeration date
11/21/2005
Last updated
03/22/2016
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