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General NPI Number Information
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NPI Number | 1588287437
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Entity Type | Organization
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Legal Business Name | SUSSMAN OBGYN LLC
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 2800 S SEACREST BLVD STE 220
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7965
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Country | US
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Telephone | 561-742-3929
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Fax | 561-742-3931
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Provider Business Mailing Address
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Address Line | 2800 S SEACREST BLVD STE 220
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7965
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Country | US
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Telephone | 561-742-3929
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Fax | 561-742-3931
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | ROBERT BRIAN SUSSMAN
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Credential | M.D.
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Telephone | 561-742-3929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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