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General NPI Number Information
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NPI Number | 1063054328
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Entity Type | Individual
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Provider Name | ALEXANDRA SUOZZO LAC
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Gender | Female
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 24 SW 10TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-1272
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Country | US
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Telephone | 800-750-8616
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Fax | 845-362-8474
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Provider Business Mailing Address
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Address Line | 26 FIREMENS MEMORIAL DR STE 115
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City | POMONA
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State | NY
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Zip | 10970-3569
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Country | US
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Telephone | 845-362-8400
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Fax | 845-362-8474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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