Provider Demographics
NPI:1982677662
Name:STREICHENWEIN, SUZAN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:MARIE
Last Name:STREICHENWEIN
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 1:3111 S DIXIE HWY
Mailing Address - Street 2:SUITE 306A
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-1557
Mailing Address - Country:US
Mailing Address - Phone:561-820-0079
Mailing Address - Fax:
Practice Address - Street 1:3111 S DIXIE HWY
Practice Address - Street 2:SUITE 306A
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-1557
Practice Address - Country:US
Practice Address - Phone:561-820-0079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-11
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00704442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0070444OtherFLORIDA STATE LICENSE
FL0070444OtherFLORIDA STATE LICENSE
FL00046251Medicare ID - Type Unspecified