DR. BENNETT PETER SCAGLIA (NPI# 1003880626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003880626 |
| Entity Type | Individual |
| Full Name | DR. BENNETT PETER SCAGLIA |
| Credential | M.D. |
| Practice Address |
311 N Clyde Morris Blvd Suite 360 Daytona Beach FL 32114-2781 |
| Mailing Address |
311 N Clyde Morris Blvd Ste 480 Daytona Beach FL 32114-2766 |
| Practice Telephone | 3862544199 |
| Practice Fax Number | 3869474680 |
| Mailing Telephone | 3864254199 |
| Mailing Fax Number | 3864254680 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | G88428 | CA | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 175031 | NY | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 036088435 | IL | Allopathic & Osteopathic Physicians |
| Y | 208800000X | Urology | ME103036 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS/BLUE SHIELD IL | 5007705 | 01 |
| IL | .36088435 | 05 | |
| FL | 000954100 | 05 |
| Street Address |
311 N CLYDE MORRIS BLVD SUITE 360 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2781 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215933056 | Gary A Wilson | Surgery | 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 | 2005-06-27 |
| 1699144436 | Diane Santopadre | Nurse Practitioner | 311 N Clyde Morris Blvd, Suite 420, Daytona Beach, FL 32114-2781 | 2015-09-23 |
| 1104207281 | Patricia Gonzalez | Nurse Anesthetist, Certified Registered | 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 | 2015-06-14 |
| 1881001162 | Kimberly W Stackpole | Physician Assistant | 311 N Clyde Morris Blvd, Suite 320, Daytona Beach, FL 32114-2781 | 2014-07-17 |
| 1871918110 | Jennifer Battani | Nurse Anesthetist, Certified Registered | 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 | 2014-02-24 |
| 1609111855 | Digon Diabetes and Endocrinology, P.a. | Internal Medicine | 311 N Clyde Morris Blvd, Suite 440, Daytona Beach, FL 32114-2781 | 2012-11-29 |
| 1063719672 | Kimberly Kay Koevenig | Dietitian, Registered | 311 N Clyde Morris Blvd, Suite 440-outpatient Diabetes Education, Halifax Health, Daytona Beach, FL 32114-2781 | 2011-02-16 |
| 1376871467 | January Y Eudy | Nurse Anesthetist, Certified Registered | 311 N Clyde Morris Blvd, Ste 350, Daytona Beach, FL 32114-2781 | 2009-12-01 |
| 1538325238 | Medical Arts Optical Service,inc | Eyewear Supplier (Equipment, not the service) | 311 N Clyde Morris Blvd, Suite 40, Daytona Beach, FL 32114-2781 | 2008-08-01 |
| 1508036419 | Eric Stephen Piazza | Physician Assistant | 311 N Clyde Morris Blvd, Suite 580, Daytona Beach, FL 32114-2781 | 2008-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932148509 | John Elbert Greene | Urology | 311 N Clyde Morris Blvd Ste 480, Daytona Beach, FL 32114-2766 | 2006-06-06 |
| 1407812092 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2006-04-24 |
| 1063484848 | Sean Tirney | Urology | 1925 S Atlantic Ave, Suite #609, Daytona Beach, FL 32118-5026 | 2006-02-06 |
| 1598015398 | Dale R Traficante Md Pa | Urology | 1890 Lpga Blvd, Suite 220, Daytona Beach, FL 32117-7138 | 2012-09-19 |
| 1598054751 | Samuel M. Lawindy | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2011-03-28 |
| 1790949873 | Evan Fynes | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2008-07-17 |
| 1043416506 | Shawn Wayne Thomas | Urology | 311 N Clyde Morris Blvd Ste 360, Daytona Beach, FL 32114-2757 | 2007-06-22 |
| 1659586840 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-11 |
| 1114148574 | Atlantic Urological Associates P A | Urology | 1620 Mason Ave, Suite E, Daytona Beach, FL 32117-7802 | 2007-05-02 |
| 1548481054 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-01 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on DR. BENNETT PETER SCAGLIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.