MEDICARE: SUSSMAN MEDICAL ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1154413409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSSMAN MEDICAL ASSOCIATES INC

Provider Business Mailing Address
First Line	:	1979 W HILLSBORO BLVD
Second Line	:	SUITE 1
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1444
Country	:	US
Telephone Number	:	954-428-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1979 W HILLSBORO BLVD
Second Line	:	SUITE 1
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1444
Country	:	US
Telephone Number	:	954-428-4800
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY EDWARD SUSSMAN
Credential	:	M.D.
Telephone Number	:	954-428-4800

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/22/2020

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