Provider Demographics
NPI:1437375680
Name:SUTHERLAND, DAVID P (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:SUTHERLAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 N ARMENIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-3828
Mailing Address - Country:US
Mailing Address - Phone:813-932-6111
Mailing Address - Fax:813-902-6231
Practice Address - Street 1:7801 N ARMENIA AVENUE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-3828
Practice Address - Country:US
Practice Address - Phone:813-932-6111
Practice Address - Fax:813-902-6231
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22907Medicare ID - Type Unspecified