Individual
DR. SANDRA JEAN SUCHOMSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP NEONATOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-4254
(904) 244-4301
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME70691
FL
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME70691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000712346A
—
GA
05
—
2500051-00
—
FL
01
—
370007156
RAILROAD MEDICARE
FL
Enumeration date
03/21/2006
Last updated
10/06/2008
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