Provider Demographics
NPI:1285656918
Name:SUSSMAN, ROBERT BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRIAN
Last Name:SUSSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S SEACREST BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7965
Mailing Address - Country:US
Mailing Address - Phone:561-742-3929
Mailing Address - Fax:561-742-3931
Practice Address - Street 1:2800 S SEACREST BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7965
Practice Address - Country:US
Practice Address - Phone:561-742-3929
Practice Address - Fax:561-742-3931
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL70511207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252212800Medicaid
FL252212802Medicaid
FL252212801Medicaid
FL252212802Medicaid