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General NPI Number Information
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NPI Number | 1124434485
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Entity Type | Individual
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Provider Name | JOSEPH SUJKA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | HARBOURSIDE MEDICAL TOWER, SUITE 740.15 5 TAMPA GENERAL CIRCLE
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City | TAMPA
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State | FL
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Zip | 33606
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Country | US
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Telephone | 813-844-4313
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 917770
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City | ORLANDO
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State | FL
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Zip | 32891-0001
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME144490
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License Number State | FL
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