Provider Demographics
NPI:1336302421
Name:BICHARA SUDAH, JOSE FELIX (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FELIX
Last Name:BICHARA SUDAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 677879
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32867-7879
Mailing Address - Country:US
Mailing Address - Phone:407-440-3004
Mailing Address - Fax:407-429-3899
Practice Address - Street 1:4882 QUALITY TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-8203
Practice Address - Country:US
Practice Address - Phone:407-440-3004
Practice Address - Fax:407-429-3899
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109349208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist