Provider Demographics
NPI:1568538783
Name:SUKAL, SEAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:A
Last Name:SUKAL
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 1:2900 NORTH MILITARY TRAIL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431
Mailing Address - Country:US
Mailing Address - Phone:561-245-8877
Mailing Address - Fax:561-322-3920
Practice Address - Street 1:2900 NORTH MILITARY TRAIL
Practice Address - Street 2:SUITE 100
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-245-8877
Practice Address - Fax:561-322-3920
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98259207N00000X, 207ND0101X
NY229964207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY229964OtherMEDICAL LICENSE
FLME98259OtherMEDICAL LICENSE
NY229964OtherMEDICAL LICENSE