MEDICARE: MS. SUZANNE WARE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	001389	IA
2	363A00000X	Physician Assistant	PA9112865	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265549083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUZANNE WARE PA-C

Provider Business Mailing Address
First Line	:	5534 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2817
Country	:	US
Telephone Number	:	971-757-2100
Fax Number	:	941-757-2101

Provider Business Practice Location Address
First Line	:	5534 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2817
Country	:	US
Telephone Number	:	971-757-2100
Fax Number	:	941-757-2101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/13/2023

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