Provider Demographics
NPI:1154467736
Name:RONNIE E SUGGS DPM PA
Entity Type:Organization
Organization Name:RONNIE E SUGGS DPM PA
Other - Org Name:CENTRAL FLORIDA FOOT CLINIC PC
Other - Org Type:Other Name
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SUGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:407-240-0002
Mailing Address - Street 1:PO BOX 593188
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32859
Mailing Address - Country:US
Mailing Address - Phone:407-240-0002
Mailing Address - Fax:407-240-0088
Practice Address - Street 1:6922 SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-3713
Practice Address - Country:US
Practice Address - Phone:407-240-0002
Practice Address - Fax:407-240-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2451213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
480021182OtherRAILROAD MEDICARE
FL390230700Medicaid
480021182OtherRAILROAD MEDICARE
FL40317Medicare ID - Type Unspecified