Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 000281 | CT |
N | 222Z00000X | Podiatrist | 000281 | CT |
N | 213EP1101X | Primary Podiatric Medicine | 000281 | CT |
N | 111NR0200X | Radiology | 000281 | CT |
N | 213ER0200X | Radiology | 000281 | CT |
N | 213ES0103X | Foot & Ankle Surgery | 000281 | CT |
Y | 213ES0103X | Foot & Ankle Surgery | POOOO2293 | FL |
NPI | 1033104062 |
---|---|
Provider Name | Larry Alan Suecof |
First Address | Orlando, FL 32803-3727 |
Second Address | Apopka, FL 32703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 17/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004006805 | (05) | CT |
0358436 | (05) | MA |
060021 | CONNECTICARE (01) | CT |
0600211278 | CONNECTICARE (01) | CT |
06-1406459 | COLONIAL COOPERATIVE CARE (01) | CT |
06-1406459 | CORVEL (01) | CT |
06-1406459 | FOCUS (01) | CT |
06-1406459 | GREAT WEST HEALTHCARE (01) | CT |
06-1406459 | HMC, PPO (01) | CT |
06-1406459 | MULTIPLAN (01) | CT |
06-1406459 | NORTHEAST HEALTH DIRECT (01) | CT |
06-1406459 | PRIVATE HEALTHCARE SYSTEM (01) | CT |
06-1406459 | UNITED HEALTHCARE (01) | CT |
0724234 001 | CIGNA (01) | CT |
0R3020 | HEALTH NET (01) | CT |
1033104062 | ANTHEM BCBS (01) | CT |
2534362 | AETNA (01) | CT |
480000668 | MEDICARE (01) | |
P4041219 | OXFORD (01) | CT |
T22674 | (02) |