Provider Demographics
NPI:1841369956
Name:FLEIGEL, SUZANNE SHIRLEY (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:SHIRLEY
Last Name:FLEIGEL
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 1:1400 SE MAGNOLIA EXT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:352-732-8173
Practice Address - Street 1:1400 SE MAGNOLIA EXT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4443
Practice Address - Country:US
Practice Address - Phone:352-732-8171
Practice Address - Fax:352-732-8173
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32415207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD85726Medicare UPIN
FL42133Medicare ID - Type Unspecified