Provider Demographics
NPI:1710031984
Name:SUNCOAST INTERNAL MEDICINE CONSULTANTS, P.A.
Entity Type:Organization
Organization Name:SUNCOAST INTERNAL MEDICINE CONSULTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PRACTITIONER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZITO
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MPH
Authorized Official - Phone:727-595-2519
Mailing Address - Street 1:13644 WALSINGHAM ROAD
Mailing Address - Street 2:S.R. #688
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3532
Mailing Address - Country:US
Mailing Address - Phone:727-595-2519
Mailing Address - Fax:727-479-0485
Practice Address - Street 1:13644 WALSINGHAM ROAD
Practice Address - Street 2:S.R. #688
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3532
Practice Address - Country:US
Practice Address - Phone:727-595-2519
Practice Address - Fax:727-479-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL77021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL059638800Medicaid
FLCK1058OtherRAILROAD MEDICARE
FLCK1058OtherRAILROAD MEDICARE