Healthcare Provider Details

I. General information

NPI: 1457436677
Provider Name (Legal Business Name): SUZANNA P BOKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8855 IMMOKALEE RD
NAPLES FL
34120-3921
US

IV. Provider business mailing address

28271 JENEVA WAY
BONITA SPRINGS FL
34135-8514
US

V. Phone/Fax

Practice location:
  • Phone: 239-331-8520
  • Fax: 239-331-8564
Mailing address:
  • Phone: 518-505-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number216489
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: