Healthcare Provider Details

I. General information

NPI: 1275596132
Provider Name (Legal Business Name): SUSAN ALVARAN ALCASID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COLLEGE DR STE 200
MIDDLEBURG FL
32068-8525
US

IV. Provider business mailing address

400 COLLEGE DR STE 200
MIDDLEBURG FL
32068-8525
US

V. Phone/Fax

Practice location:
  • Phone: 904-213-2700
  • Fax: 352-384-8032
Mailing address:
  • Phone: 904-213-2700
  • Fax: 352-384-8032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35077430A
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: