Basic Information
| Provider Information | |||||||||
| NPI: | 1356385397 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOLARO | ||||||||
| FirstName: | VINCENT | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 S VOLUSIA AVE | ||||||||
| Address2: | |||||||||
| City: | ORANGE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327635839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867757500 | ||||||||
| FaxNumber: | 3867751904 | ||||||||
| Practice Location | |||||||||
| Address1: | 2555 S KIRKMAN RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328112346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073622030 | ||||||||
| FaxNumber: | 4073622040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 09/14/2016 | ||||||||
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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 | 207Q00000X | OS5974 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.