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Individual

SU XU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4915 EHRLICH RD, TAMPA, FL 33624
(813) 960-2400
(813) 960-2410
Mailing address
15416 N FLORIDA AVE, TAMPA, FL 33613-1244
(813) 960-2400
(813) 960-2410

Taxonomy

Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
ME90020
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME90020
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0081220
CIGNA
FL
05
102177400
FL
01
43262
FL BLUE
FL
01
592235385
MULTIPLAN
FL
01
592235685
UNITED HC
FL
01
7367680
AETNA
FL
Enumeration date
06/16/2008
Last updated
09/12/2019
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