# SUPPORTIVE MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427882356
- **Authorized official:** DR. SUFANA A AL KHUNAIZI MD (MD)
- **Authorized official phone:** (626) 389-7410

## Contact information

- **Practice address:** 11117 REGATTA LN, WELLINGTON, FL 33449-7416
- **Practice address phone:** (626) 389-7410
- **Mailing address:** 11117 REGATTA LN, WELLINGTON, FL 33449-7416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | — | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/02/2024
- **Last updated:** 09/02/2024