Organization
SUPPORTIVE MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUFANA A AL KHUNAIZI MD (MD)
(626) 389-7410
Entity
Organization
Contact information
Practice address
11117 REGATTA LN, WELLINGTON, FL 33449-7416
(626) 389-7410
Mailing address
11117 REGATTA LN, WELLINGTON, FL 33449-7416
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2024
Last updated
09/02/2024
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