Provider Demographics
NPI:1538649157
Name:PAIGE, SUZANNE PATRICE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:PATRICE
Last Name:PAIGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:PATRICE
Other - Last Name:MESSADO -WEDDERBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:1503 BUENOS AIRES BLVD
Practice Address - Street 2:BLDG. 140
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6823
Practice Address - Country:US
Practice Address - Phone:352-750-5105
Practice Address - Fax:352-750-5138
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9293797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9293797OtherARNP NUMBER