Provider Demographics
NPI:1033288592
Name:SAXE, SUSAN E (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:SAXE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 NW 15TH STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486
Mailing Address - Country:US
Mailing Address - Phone:561-393-8224
Mailing Address - Fax:561-367-9727
Practice Address - Street 1:1050 NW 15TH STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-393-8224
Practice Address - Fax:561-367-9727
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057792207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F26850Medicare UPIN
14998XMedicare ID - Type Unspecified