Provider Demographics
NPI:1750030755
Name:RAC, SUSANA (MD)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:RAC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 TURTLE HATCH LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-8538
Mailing Address - Country:US
Mailing Address - Phone:224-410-0159
Mailing Address - Fax:
Practice Address - Street 1:525 TURTLE HATCH LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8538
Practice Address - Country:US
Practice Address - Phone:224-410-0159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program