Provider Demographics
NPI:1851004519
Name:SUCHOMELLY, LINDZY TAYLOR (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDZY
Middle Name:TAYLOR
Last Name:SUCHOMELLY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:633 EASTLAKE CLUB DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2471
Mailing Address - Country:US
Mailing Address - Phone:727-410-8025
Mailing Address - Fax:
Practice Address - Street 1:100 LACY ST NW STE 150
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1273
Practice Address - Country:US
Practice Address - Phone:770-793-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2023-07-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant