Organization
INDIAN RIVER HEALTH SERVICES INC
Active
Other names
PREMIER WOMENS HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY L SUSI (CEO)
(772) 567-4311
Entity
Organization
Contact information
Practice address
3450 11TH CT, SUITE 304, VERO BEACH, FL 32960-5012
(772) 770-6801
(772) 770-6802
Mailing address
PO BOX 830270, MSC #375, BIRMINGHAM, AL 35283-0270
(772) 567-4311
(772) 794-1450
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
4029
FL
Other
Enumeration date
02/08/2017
Last updated
09/16/2019
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