Provider Demographics
NPI:1649890492
Name:WOLSKI, SUZANNA KAREN (OD)
Entity type:Individual
Prefix:DR
First Name:SUZANNA
Middle Name:KAREN
Last Name:WOLSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10445 GALLERIA ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3157
Mailing Address - Country:US
Mailing Address - Phone:931-220-7208
Mailing Address - Fax:
Practice Address - Street 1:10300 FOREST HILL BLVD STE 161
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3124
Practice Address - Country:US
Practice Address - Phone:561-798-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5774152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist