Healthcare Provider Details

I. General information

NPI: 1881863462
Provider Name (Legal Business Name): SUZANNE KATHLEEN BRYSKIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 MAITLAND AVE
ALTAMONTE SPRINGS FL
32701-6835
US

IV. Provider business mailing address

337 MINNEHAHA RD
MAITLAND FL
32751-4593
US

V. Phone/Fax

Practice location:
  • Phone: 407-755-1818
  • Fax: 407-755-1819
Mailing address:
  • Phone: 919-357-7860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME101068
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: