Individual
THAWATCHAI SUKSANONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1752 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33704-4206
(727) 823-7224
(727) 821-3568
Mailing address
PO BOX 22766, TAMPA, FL 33622-2766
(727) 823-2188
(727) 823-9502
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0031934
FL
Other
Enumeration date
03/29/2006
Last updated
11/26/2007
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