Provider Demographics
NPI:1881863462
Name:BRYSKIN, SUZANNE KATHLEEN (MD)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:KATHLEEN
Last Name:BRYSKIN
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 1:6334 SAN JOSE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217
Mailing Address - Country:US
Mailing Address - Phone:919-357-7860
Mailing Address - Fax:
Practice Address - Street 1:3129 HENDRICKS AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4217
Practice Address - Country:US
Practice Address - Phone:904-398-8266
Practice Address - Fax:904-396-4803
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101068207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM436ZMedicare PIN