MEDICARE: KATHRYN LEE ANDERSON SUTTON M.D.

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	207R00000X	Internal Medicine Physician	218781	NC
2	207N00000X	Dermatology Physician	ME145243	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	:	1891149993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN LEE ANDERSON SUTTON M.D.

Provider Business Mailing Address
First Line	:	1155 35TH LN STE 202
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-6537
Country	:	US
Telephone Number	:	772-770-6871
Fax Number	:	772-226-4805

Provider Business Practice Location Address
First Line	:	1155 35TH LN STE 202
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-6537
Country	:	US
Telephone Number	:	772-770-6871
Fax Number	:	772-226-4805

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

Provider Enumeration Date	:	04/15/2016
Last Update Date	:	05/04/2026

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