MEDICARE: RHETT SUTHERLAND I DC

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	111N00000X	Chiropractor	12505	FL

General Provider Information

NPI Number	:	1265918437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHETT SUTHERLAND I DC

Provider Business Mailing Address
First Line	:	5750 CANTON CV
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5079
Country	:	US
Telephone Number	:	954-401-3329
Fax Number	:

Provider Business Practice Location Address
First Line	:	5750 CANTON CV
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5079
Country	:	US
Telephone Number	:	407-636-3106
Fax Number	:

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

Provider Enumeration Date	:	07/11/2018
Last Update Date	:	11/01/2023

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Directions to “ RHETT SUTHERLAND I DC” Practice Location

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