Provider Demographics
NPI:1427733310
Name:SCOTT, DANIEL GASTON (DO6207)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:GASTON
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO6207
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 CYPRESS GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-6200
Mailing Address - Country:US
Mailing Address - Phone:863-318-0329
Mailing Address - Fax:863-318-0348
Practice Address - Street 1:7450 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-6200
Practice Address - Country:US
Practice Address - Phone:863-318-0329
Practice Address - Fax:863-318-0348
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6207156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician