Individual
DR. SUSAN ST.CLAIR ROPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2467 ENTERPRISE RD STE A, CLEARWATER, FL 33763-1724
(727) 791-1411
(727) 791-1419
Mailing address
2467 ENTERPRISE RD, STE A, CLEARWATER, FL 33763-1724
(727) 791-1411
(727) 791-1419
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME46341
FL
207ND0101X
MOHS-Micrographic Surgery Physician
46341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114039732
NPI
—
01
—
79962
BLUE CROSS/BLUE SHIELD
FL
01
—
K1008
PTAN
—
Enumeration date
08/31/2006
Last updated
01/13/2022
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