| Suksanong And Suksanong Mds Pa | |
|
1752 Mlk Jr St N St Petersburg FL 33704-4206 | |
| (727) 823-7224 | |
| (727) 489-9486 |
| Full Name | Suksanong And Suksanong Mds Pa |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 1752 Mlk Jr St N, St Petersburg, Florida |
| Authorized Official Name and Position | Mingquan Suksanong (VP) |
| Authorized Official Contact | 7278237224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suksanong And Suksanong Mds Pa Po Box 1945 Palm Harbor FL 34682-1945 Ph: (727) 771-1300 | Suksanong And Suksanong Mds Pa 1752 Mlk Jr St N St Petersburg FL 33704-4206 Ph: (727) 823-7224 |
| NPI Number | 1528249687 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 05/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528249687 | NPI | - | NPPES |
| DQ8992 | Other | FL | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME31666 (Florida) | Primary |
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