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NPI Code Detail

MEDICARE: PAUL STEVEN SUDACK MD

MEDICARE:   PAUL STEVEN SUDACK  MD
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
1208000000XPediatrics Physician41103FL

General Provider Information

NPI Number : 1528130754
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL STEVEN SUDACK MD
Provider Business Mailing Address
First Line : 215 WESTWARD DR
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-5259
Country : US
Telephone Number : 305-887-4494
Fax Number : 305-887-1475
Provider Business Practice Location Address
First Line : 215 WESTWARD DR
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-5259
Country : US
Telephone Number : 305-887-4494
Fax Number : 305-887-1475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/08/2007

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Directions to “ PAUL STEVEN SUDACK MD” Practice Location

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