Provider Demographics
NPI:1457348815
Name:ALKADRY, SUHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUHA
Middle Name:
Last Name:ALKADRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUHA
Other - Middle Name:
Other - Last Name:QADRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:303 N CLYDE MORRIS BLVD
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-425-2285
Mailing Address - Fax:386-425-7522
Practice Address - Street 1:303 N CLYDE MORRIS BLVD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2709
Practice Address - Country:US
Practice Address - Phone:386-425-2285
Practice Address - Fax:386-425-7522
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97493208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91314OtherBCBS
FL277581600Medicaid
MO204732218Medicaid
MO009013435Medicare ID - Type UnspecifiedMEDICARE
FL277581600Medicaid