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General NPI Number Information
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NPI Number | 1073501789
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Entity Type | Individual
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Provider Name | LUIS R. ANNONI-SUAU MD
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Gender | Male
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 14100 FIVAY RD SUITE 310
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City | HUDSON
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State | FL
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Zip | 34667
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Country | US
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Telephone | 727-862-3202
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Fax | 727-862-2182
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Provider Business Mailing Address
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Address Line | 2035 LITTLE ROAD
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City | TRINITY
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State | FL
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Zip | 34655
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Country | US
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Telephone | 727-862-3202
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Fax | 727-862-2182
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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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | ME68092
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License Number State | FL
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