Healthcare Provider Details

I. General information

NPI: 1639175557
Provider Name (Legal Business Name): SUZANNE STEELE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 W SUNRISE BLVD
PLANTATION FL
33322-5426
US

IV. Provider business mailing address

480 QUADRANGLE DR STE 200
BOLINGBROOK IL
60440-3414
US

V. Phone/Fax

Practice location:
  • Phone: 786-530-6543
  • Fax:
Mailing address:
  • Phone: 800-809-1012
  • Fax: 317-428-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD058789L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number77389
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: