Healthcare Provider Details

I. General information

NPI: 1609869429
Provider Name (Legal Business Name): SUSAN BINOY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 S MCCALL RD
ENGLEWOOD FL
34224-6400
US

IV. Provider business mailing address

2650 S MCCALL RD
ENGLEWOOD FL
34224-6400
US

V. Phone/Fax

Practice location:
  • Phone: 941-475-9559
  • Fax: 941-473-3557
Mailing address:
  • Phone: 941-475-9559
  • Fax: 941-473-3557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME81384
License Number StateFL

VIII. Authorized Official

Name: DR. SUSAN A BINOY
Title or Position: PHYSICIAN
Credential: M.D., P.A.
Phone: 941-475-9559