Provider Demographics
NPI:1720789431
Name:DEVLIN, SCOTT (PTA)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 S BRINK AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-4203
Mailing Address - Country:US
Mailing Address - Phone:703-477-6369
Mailing Address - Fax:
Practice Address - Street 1:1301 N TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-2402
Practice Address - Country:US
Practice Address - Phone:703-477-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant