Individual
DR. FELIPE PORTO DE SOUZA SUPLICY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
705 N DIVISION ST NW, ROME, GA 30165-1454
(808) 489-1187
(352) 265-3285
Mailing address
4000 NW 51ST ST, 120, GAINESVILLE, FL 32606-4333
(808) 489-1187
(352) 265-3285
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
TRN14128
FL
2084P0800X
Psychiatry Physician
64763
GA
2084P0800X
Psychiatry Physician
Primary
MDR-4822
HI
Other
Enumeration date
05/21/2007
Last updated
07/22/2010
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