Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME33712 | FL |
NPI | 1376500645 |
---|---|
Provider Name | Pamela M Sutton |
First Address | Orlando, FL 32886-2851 |
Second Address | Fort Lauderdale, FL 33316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 04/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
037610800 | (05) | FL |
D60530 | (02) |