Basic Information
Provider Information
NPI: 1376642231
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NORRIS
FirstName: SCOTT
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4215 BURNS RD STE 200
Address2:  
City: PALM BEACH GARDENS
State: FL
PostalCode: 334104625
CountryCode: US
TelephoneNumber: 5916947776
FaxNumber: 5616943099
Practice Location
Address1: 2055 MILITARY TRL STE 200
Address2:  
City: JUPITER
State: FL
PostalCode: 334587830
CountryCode: US
TelephoneNumber: 5916947776
FaxNumber: 5616943099
Other Information
ProviderEnumerationDate: 09/21/2006
LastUpdateDate: 05/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XOS8259FLN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0005XOS8259FLY Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


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