Healthcare Provider Details

I. General information

NPI: 1366564882
Provider Name (Legal Business Name): DAVID SUOMELA D.O.M., A.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SE 15TH TER
DEERFIELD BEACH FL
33441-4428
US

IV. Provider business mailing address

225 SE 15TH TER
DEERFIELD BEACH FL
33441-4428
US

V. Phone/Fax

Practice location:
  • Phone: 954-234-6005
  • Fax:
Mailing address:
  • Phone: 954-234-6005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2326
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: