Healthcare Provider Details

I. General information

NPI: 1174545735
Provider Name (Legal Business Name): RONNIE EUGENE SUGGS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6922 SEMINOLE DR
BELLE ISLE FL
32812-3713
US

IV. Provider business mailing address

PO BOX 593188
ORLANDO FL
32859-3188
US

V. Phone/Fax

Practice location:
  • Phone: 407-240-0002
  • Fax: 407-240-0088
Mailing address:
  • Phone: 407-240-0002
  • Fax: 407-240-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO2451
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: