Healthcare Provider Details

I. General information

NPI: 1093122277
Provider Name (Legal Business Name): VIKY SUNCION LOESCHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIKY YANINA SUNCION MD

II. Dates (important events)

Enumeration Date: 07/19/2014
Last Update Date: 02/08/2020
Certification Date: 02/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

3119 FILLMORE ST
HOLLYWOOD FL
33021-7025
US

V. Phone/Fax

Practice location:
  • Phone: 305-535-7901
  • Fax: 305-674-2787
Mailing address:
  • Phone: 305-319-2727
  • Fax: 305-585-8137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME134095
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: