Provider Demographics
NPI:1548260086
Name:ELSBREE, SCOTT B (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:B
Last Name:ELSBREE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6270 LAKE OSPREY DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8425
Mailing Address - Country:US
Mailing Address - Phone:941-342-1333
Mailing Address - Fax:941-907-8206
Practice Address - Street 1:6270 LAKE OSPREY DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-8425
Practice Address - Country:US
Practice Address - Phone:941-342-1333
Practice Address - Fax:941-907-8206
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47274207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00464571OtherRAIL ROAD MEDICARE
FL045565200Medicaid
FL58486OtherBCBS
FL110207269OtherMEDICARE RAILROAD
FLP00464571OtherRAIL ROAD MEDICARE
FLD56992Medicare UPIN
FL58486YMedicare PIN
FL110207269OtherMEDICARE RAILROAD