Provider Demographics
NPI:1396722898
Name:LABOHN, SCOTT M (DPM)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:M
Last Name:LABOHN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:2835 W DE LEON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4168
Mailing Address - Country:US
Mailing Address - Phone:813-254-6592
Mailing Address - Fax:813-254-3634
Practice Address - Street 1:38105 13TH AVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-3437
Practice Address - Country:US
Practice Address - Phone:813-715-4747
Practice Address - Fax:813-783-8937
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2011-07-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPO0002591213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65516OtherBLUE CROSS BLUE SHIELD
FL2700469OtherUNITED HEALTHCARE
FL2700469OtherUNITED HEALTHCARE
FL480029682Medicare PIN
FLU58496Medicare UPIN