Provider Demographics
NPI:1821235581
Name:PREBLE, SUZETTE SOPHIA (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:SOPHIA
Last Name:PREBLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13747 50TH PL N
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8155
Mailing Address - Country:US
Mailing Address - Phone:561-860-0348
Mailing Address - Fax:
Practice Address - Street 1:2677 FOREST HILL BLVD
Practice Address - Street 2:SUITE 102-103
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5949
Practice Address - Country:US
Practice Address - Phone:561-433-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 50419175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath