Provider Demographics
NPI:1891801197
Name:SUCHANEK, MELANIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:M
Last Name:SUCHANEK
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 1:5509 GRAND BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-3836
Mailing Address - Country:US
Mailing Address - Phone:727-232-0644
Mailing Address - Fax:866-615-6461
Practice Address - Street 1:5509 GRAND BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3836
Practice Address - Country:US
Practice Address - Phone:727-232-0644
Practice Address - Fax:866-615-6461
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96800207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277408900Medicaid
FLP00404899OtherRAILROAD MEDICARE NUMBER
FLP00404899OtherRAILROAD MEDICARE NUMBER
FL277408900Medicaid