Provider Demographics
NPI:1346517562
Name:SCANDIN, DEBORAH LYNN (AP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNN
Last Name:SCANDIN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3293 FRUITVILLE RD UNIT 104
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-6453
Mailing Address - Country:US
Mailing Address - Phone:843-824-4080
Mailing Address - Fax:941-955-8886
Practice Address - Street 1:3293 FRUITVILLE RD UNIT 104
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6453
Practice Address - Country:US
Practice Address - Phone:843-824-4080
Practice Address - Fax:941-955-8886
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4494171100000X
FL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist