Individual
IHOR IHOROVYCH SUSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3900 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4331
(904) 222-6656
(904) 222-6667
Mailing address
3900 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4331
(904) 222-6656
(904) 222-6657
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11027667
FL
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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