MEDICARE: REBECCA SUKUL OD

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	152W00000X	Optometrist	OPC6458	FL

General Provider Information

NPI Number	:	1932958121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SUKUL OD

Provider Business Mailing Address
First Line	:	7124 BERACASA WAY
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3448
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7124 BERACASA WAY
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3448
Country	:	US
Telephone Number	:	561-750-7744
Fax Number	:

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

Provider Enumeration Date	:	05/18/2024
Last Update Date	:	02/25/2026

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