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Organization

FLORIDA MAXILLOFACIAL AND RECONSTRUCTIVE SURGERY PA

Active
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Organization

FLORIDA MAXILLOFACIAL AND RECONSTRUCTIVE SURGERY PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TERRY SU MD (OWNER/MD)
(407) 463-9588
Entity
Organization

Contact information

Practice address
7350 SANDLAKE COMMONS BLVD STE 2212A, ORLANDO, FL 32819-8031
(407) 463-9588
(949) 798-7844
Mailing address
PO BOX 1112, WINDERMERE, FL 34786-1112
(407) 463-9588
(949) 798-7844

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—

Other

Enumeration date
06/03/2022
Last updated
02/26/2025
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