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General NPI Number Information
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NPI Number | 1598943508
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Entity Type | Organization
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Legal Business Name | CHARLES SUIVSKI OD PA
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2341 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-4528
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Country | US
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Telephone | 772-283-4240
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Fax | 772-221-2422
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Provider Business Mailing Address
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Address Line | 2341 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-4528
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Country | US
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Telephone | 772-283-4240
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Fax | 772-221-2422
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Authorized Official
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Title or Position | ADMINISTRATIVE SUPERVISOR
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Name | DANA SUIVSKI
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Credential |
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Telephone | 772-286-9233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC2457
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License Number State | FL
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