Provider Demographics
NPI:1699738963
Name:PLUSKIS, SCOTT R (ATC/L)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:R
Last Name:PLUSKIS
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 NW 62ND ST
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2146
Mailing Address - Country:US
Mailing Address - Phone:954-478-0302
Mailing Address - Fax:561-488-1064
Practice Address - Street 1:3817 NW 62ND ST
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-2146
Practice Address - Country:US
Practice Address - Phone:954-478-0302
Practice Address - Fax:561-488-1064
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL6712255A2300X
FLBMO 66516247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist