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NPI Code Detail

MEDICARE: SUZANNE S KNOEPPEL D.O.

MEDICARE:   SUZANNE S KNOEPPEL  D.O.
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
1207Q00000XFamily Medicine PhysicianOS5507FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
280058OTHERFLBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679547152
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE S KNOEPPEL D.O.
Provider Business Mailing Address
First Line : 13515 LAKE TERRACE LN
Second Line :
City : TAMPA
State : FL
Zip : 33637-1003
Country : US
Telephone Number : 813-998-8000
Fax Number :
Provider Business Practice Location Address
First Line : 13515 LAKE TERRACE LN
Second Line :
City : TAMPA
State : FL
Zip : 33637-1003
Country : US
Telephone Number : 813-998-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 12/16/2016

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Directions to “ SUZANNE S KNOEPPEL D.O.” Practice Location

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