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General NPI Number Information
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NPI Number | 1346851797
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Entity Type | Individual
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Provider Name | SUZY SAMEH FARAG MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 1776 N. WILLIAMSON BLVD.
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City | DAYTONA BEACH
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State | FL
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Zip | 32117
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Country | US
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Telephone | 386-323-7500
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Fax | 203-573-7031
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Provider Business Mailing Address
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Address Line | 1325 TOMOKA TOWN CENTER DRIVE APT 404
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City | DAYTONA BEACH
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State | FL
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Zip | 32117
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Country | US
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Telephone | 561-563-3331
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Fax | 203-573-6707
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 164827
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License Number State | FL
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