Provider Demographics
NPI:1598781395
Name:HUANG, SUBER S (MD)
Entity Type:Individual
Prefix:
First Name:SUBER
Middle Name:S
Last Name:HUANG
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 1:3880 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3504
Mailing Address - Country:US
Mailing Address - Phone:239-659-3937
Mailing Address - Fax:
Practice Address - Street 1:1611 S GREEN RD STE 230
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-4134
Practice Address - Country:US
Practice Address - Phone:216-381-3366
Practice Address - Fax:216-382-4959
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-060299207W00000X, 207WX0107X
FLME130276207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000127584OtherANTHEM
OH0806837Medicaid
OH363651OtherWELLCARE
OHP00368433OtherRAILROAD MEDICARE
OH000000221120OtherUNISON
OH738063OtherBUCKEYE
OH000000512666OtherANTHEM
OH0661146OtherAETNA
OH363651OtherWELLCARE
OHE54245Medicare UPIN
OHP00368433OtherRAILROAD MEDICARE