Basic Information
| Provider Information | |||||||||
| NPI: | 1437198157 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT-HOLMAN | ||||||||
| FirstName: | SANDI | ||||||||
| MiddleName: | DEE | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6441 HANCOCK RD | ||||||||
| Address2: | |||||||||
| City: | SOUTHWEST RANCHES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333303441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546807010 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3200 S UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | DAVIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333282018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542624100 | ||||||||
| FaxNumber: | 9542623815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 03/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS0006858 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.