Provider Demographics
NPI:1003019688
Name:SUMA, PAMELA DIANE
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DIANE
Last Name:SUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10503 W THUNDERBIRD BLVD STE 263A
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3048
Mailing Address - Country:US
Mailing Address - Phone:623-888-3370
Mailing Address - Fax:480-795-6158
Practice Address - Street 1:10503 W. THUNDERBIRD BLVD
Practice Address - Street 2:SUITE 263A
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:623-888-3370
Practice Address - Fax:480-795-6158
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ2744225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist