Individual
SUKANYA PACHAIDEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 E NASA BLVD, SUITE 200, MELBOURNE, FL 32901-1950
(321) 676-6322
(321) 722-1879
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 676-6322
(321) 722-1879
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
ME90829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270174000
—
FL
01
—
P00144837
RR MEDICARE
FL
Enumeration date
12/01/2005
Last updated
07/21/2022
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