Organization
FLORIDA MAXILLOFACIAL AND RECONSTRUCTIVE SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY SU MD (OWNER/MD)
(407) 463-9588
Entity
Organization
Contact information
Practice address
7350 SANDLAKE COMMONS BLVD STE 2212A, ORLANDO, FL 32819-8031
(407) 463-9588
(949) 798-7844
Mailing address
PO BOX 1112, WINDERMERE, FL 34786-1112
(407) 463-9588
(949) 798-7844
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
06/03/2022
Last updated
02/26/2025
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