Provider Demographics
NPI:1003108283
Name:EL-YAZIGI, SUZANNA (DC)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:
Last Name:EL-YAZIGI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SUZI
Other - Middle Name:
Other - Last Name:YAZIGI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:12627 SAN JOSE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8637
Mailing Address - Country:US
Mailing Address - Phone:904-683-9698
Mailing Address - Fax:904-683-3941
Practice Address - Street 1:12627 SAN JOSE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8637
Practice Address - Country:US
Practice Address - Phone:904-683-9698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor