Healthcare Provider Details

I. General information

NPI: 1811982945
Provider Name (Legal Business Name): JAMES M. SUTHERLAND DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 MEDICAL CENTER DR STE 102
ORANGE CITY FL
32763-8225
US

IV. Provider business mailing address

1061 MEDICAL CENTER DR STE 310
ORANGE CITY FL
32763-8227
US

V. Phone/Fax

Practice location:
  • Phone: 386-917-7620
  • Fax: 386-917-7621
Mailing address:
  • Phone: 386-917-7620
  • Fax: 386-917-7621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS8951
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0102201917
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberOS8951
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberOS8951
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: