Basic Information
| Provider Information | |||||||||
| NPI: | 1194790253 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GASIOREK | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2160 COLONIAL BLVD | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339071410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399317342 | ||||||||
| FaxNumber: | 2399317385 | ||||||||
| Practice Location | |||||||||
| Address1: | 3650 EMERGENCY LN | ||||||||
| Address2: | |||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338705534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8633828811 | ||||||||
| FaxNumber: | 8633826055 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2006 | ||||||||
| LastUpdateDate: | 02/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | ME 44463 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 43103 | 01 | FL | BCBS | OTHER | P938830 | 01 | FL | OPTIMUM | OTHER | P997942 | 01 | FL | FREEDOM | OTHER | 1249228 | 01 | FL | WELLCARE | OTHER | 1613633 | 01 | FL | CIGNA | OTHER | 4224437 | 01 | FL | AETNA | OTHER | 044174100 | 05 | FL | MEDICAID | 337674 | 01 | FL | AVMED | OTHER | P01572579 | 01 | FL | RR MEDICARE | OTHER |