Provider Demographics
NPI:1962678383
Name:MICHELLE R SCARGLE MD PA
Entity type:Organization
Organization Name:MICHELLE R SCARGLE MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-514-0065
Mailing Address - Street 1:2454 N MCMULLEN BOOTH RD STE 502
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1340
Mailing Address - Country:US
Mailing Address - Phone:727-285-8770
Mailing Address - Fax:727-285-8774
Practice Address - Street 1:2454 N MCMULLEN BOOTH RD STE 501-504
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1353
Practice Address - Country:US
Practice Address - Phone:727-285-8770
Practice Address - Fax:727-285-8774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL927922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty