Provider Demographics
NPI:1396097473
Name:MEDLIN, SCOTT E (DVM)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:MEDLIN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28400 OLD 41 RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-6812
Mailing Address - Country:US
Mailing Address - Phone:239-992-8387
Mailing Address - Fax:
Practice Address - Street 1:28400 OLD 41 RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-6812
Practice Address - Country:US
Practice Address - Phone:239-992-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12153174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian