Carroll, Jerry Scott

Carroll, Jerry Scott is an individual health care provider with primary practice located at 734 N 3Rd St Suite 115, Leesburg FL 34748-5285. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Magnetic Resonance Imaging (MRI). Allopathic & Osteopathic Physicians / Magnetic Resonance Imaging (MRI) is his primary health care specialty. Carroll, Jerry Scott can be contacted via phone (352) 365-2583.

Contact Information

Primary practice address
734 N 3Rd St Suite 115 Leesburg FL 34748-5285
Phone: (352) 365-2583
Fax: (352) 728-6749
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME109665 Florida
Allopathic & Osteopathic Physicians / Magnetic Resonance Imaging (MRI) 207RM1200X ME109665 Florida

Profile Details

NPI number 1497931406
LBN Legal business name Carroll, Jerry Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 21st, 2008
Last updated Aug 26th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497931406 NPPES
Florida Other P00986156 RR MEDICARE RACF
Florida Other P00986170 RR MEDICARE RACF
Florida MEDICAID 03876000 RR MEDICARE RACF

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