RONNIE E SUGGS DPM PA (CENTRAL FLORIDA FOOT CLINIC PC) - NPI NUMBER 1154467736

Summary

Provider Name: RONNIE E SUGGS DPM PA (CENTRAL FLORIDA FOOT CLINIC PC)

NPI Number: 1154467736

Clasification: Podiatrist (213E00000X)

Address:
6922 SEMINOLE DR
ORLANDO, FL
ZIP 32812

Phone Number: (407) 240-0002



Detailed Information

RONNIE E SUGGS DPM PA is a podiatrist in Orlando, FL. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. The assigned NPI number for this provider is 1154467736 and is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Central Florida Foot Clinic Pc.

The provider's business address is:

6922 SEMINOLE DR
ORLANDO, FL
ZIP 32812-713
Phone: (407) 240-0002
Fax: (407) 240-0088

The provider's authorized official is Ronnie Eugene Suggs .
The authorized official title is Podiatrist and has the following contact phone number (407) 240-0002.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 6/13/2008.

Map - Location of Practice

Similar Providers

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 213E00000X Podiatrist PO2451 FL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 390230700 MEDICAID FL
2 40317 MEDICARE ID-TYPE UNSPECIFIED FL
3 T61117 MEDICARE UPIN
4 480021182 OTHER RAILROAD MEDICARE

NPI Record

No. Field Name Field Value
1 NPI 1154467736
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name RONNIE E SUGGS DPM PA
5 Provider Other Organization Name CENTRAL FLORIDA FOOT CLINIC PC
6 Provider Other Organization Name Type Code 5
7 Provider First Line Business Practice Location Address 6922 SEMINOLE DR
8 Provider Business Practice Location Address City Name ORLANDO
9 Provider Business Practice Location Address State Name FL
10 Provider Business Practice Location Address Postal Code 328123713
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 4072400002
13 Provider Business Practice Location Address Fax Number 4072400088
14 Provider Enumeration Date 1/30/2007
15 Last Update Date 6/13/2008
16 Authorized Official Last Name SUGGS
17 Authorized Official First Name RONNIE
18 Authorized Official Middle Name EUGENE
19 Authorized Official Title or Position PODIATRIST
20 Authorized Official Telephone Number 4072400002
21 Healthcare Provider Taxonomy Code 1 213E00000X
22 Provider License Number 1 PO2451
23 Provider License Number State Code 1 FL
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 390230700
26 Other Provider Identifier Type Code 1 05
27 Other Provider Identifier State 1 FL
28 Other Provider Identifier 2 40317
29 Other Provider Identifier Type Code 2 04
30 Other Provider Identifier State 2 FL
31 Other Provider Identifier 3 T61117
32 Other Provider Identifier Type Code 3 02
33 Other Provider Identifier 4 480021182
34 Other Provider Identifier Type Code 4 01
35 Other Provider Identifier Issuer 4 RAILROAD MEDICARE
36 Is Organization Subpart N
37 Authorized Official Name Prefix Text DR.
38 Authorized Official Credential Text DPM
39 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 8/12/2014
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