Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Logan Scott Lauderdale

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1427730126

Logan Scott Lauderdale is a Physician Assistant in Jacksonville, Florida. Qualified in 2023, 3 years ago. Practices with Southeast Orthopedic Specialists LLC, a 145-clinician group and works from 12 locations. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone: (904) 634-0640
Fax: (904) 634-0203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (11)

  • 4565 Us Highway 17 Ste 17, Fleming Island, FL 32003-4842 — (904) 634-0640
  • 2627 Riverside Ave Ste 300, Jacksonville, FL 32204-4717 — (904) 634-0640
  • 6675 Corporate Center Pkwy Ste 115, Jacksonville, FL 32216-8088 — (904) 245-8910
  • 15255 Max Legget Pkwy Ste 5300, Jacksonville, FL 32218-7274 — (904) 634-0640
  • 4268 Oldfield Crossing Dr Ste 201, Jacksonville, FL 32223-8800 — (904) 634-0640
  • 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 — (904) 634-0640
  • 2300 Park Ave Ste 206, Orange Park, FL 32073-5573 — (904) 634-0640
  • 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 — (904) 634-0640
  • 1690 Us Highway 1 S Ste F, St Augustine, FL 32084-6024 — (904) 634-0640
  • 216 Southpark Cir E Ste 216, St Augustine, FL 32086-5135 — (904) 634-0640
  • 3055 County Road 210 W Ste 210, St Johns, FL 32259-7000 — (904) 634-0640

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9118127 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1427730126
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 2, 2023
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Southeast Orthopedic Specialists Llc — 145 clinicians
Accepts Medicare assignment Not indicated
Practice locations6 on file with Medicare

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