MEDICARE: SUZANNE ELIZABETH RUNGE NP-C

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	363LF0000X	Family Nurse Practitioner	9263514	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245663038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE ELIZABETH RUNGE NP-C

Provider Business Mailing Address
First Line	:	3255 S US HIGHWAY 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6381
Country	:	US
Telephone Number	:	772-742-9270
Fax Number	:	855-531-6012

Provider Business Practice Location Address
First Line	:	3255 S US HIGHWAY 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6381
Country	:	US
Telephone Number	:	772-742-9270
Fax Number	:	855-531-6012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2013
Last Update Date	:	07/29/2025

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