Provider Demographics
NPI:1265918437
Name:SUTHERLAND, RHETT I (DC)
Entity type:Individual
Prefix:
First Name:RHETT
Middle Name:
Last Name:SUTHERLAND
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 CANTON CV
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5079
Mailing Address - Country:US
Mailing Address - Phone:954-401-3329
Mailing Address - Fax:
Practice Address - Street 1:5750 CANTON CV
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5079
Practice Address - Country:US
Practice Address - Phone:407-636-3106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor