Healthcare Provider Details

I. General information

NPI: 1174185706
Provider Name (Legal Business Name): SUSANNA MARIA ZURECKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE SALERNO RD
STUART FL
34997-6503
US

IV. Provider business mailing address

PO BOX 77000
DETROIT MI
48277-1797
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-2300
  • Fax:
Mailing address:
  • Phone: 989-583-4220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME170646
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301507795
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4351045123
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: