Provider Demographics
NPI:1144403882
Name:DR THOMAS C SUITS MD PA
Entity type:Organization
Organization Name:DR THOMAS C SUITS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:SUITS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:772-220-9871
Mailing Address - Street 1:401 SE OSCEOLA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2503
Mailing Address - Country:US
Mailing Address - Phone:772-220-9871
Mailing Address - Fax:
Practice Address - Street 1:401 E OSCEOLA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2503
Practice Address - Country:US
Practice Address - Phone:772-220-9871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057977174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260939300Medicaid
FLCB6757OtherRAILROAD MEDICARE
FLCB6757OtherRAILROAD MEDICARE
FL260939300Medicaid
FLE71125Medicare UPIN