Healthcare Provider Details

I. General information

NPI: 1447578448
Provider Name (Legal Business Name): SUSAN MARIE BUDOWSKY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 E HALLANDALE BEACH BLVD
HALLANDALE BEACH FL
33009-4488
US

IV. Provider business mailing address

603 N FLAMINGO RD SUITE 251
PEMBROKE PINES FL
33028-1023
US

V. Phone/Fax

Practice location:
  • Phone: 954-454-6300
  • Fax:
Mailing address:
  • Phone: 954-430-3999
  • Fax: 954-430-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9101134
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: