Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA 50419 | FL |
NPI | 1821235581 |
---|---|
Provider Name | Mrs. Suzette Sophia Preble |
First Address | Royal Palm Beach, FL 33411-8155 |
Second Address | West Palm Beach, FL 33406-5949 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2009 |
Last Update Date | 10/11/2009 |