Provider Demographics
NPI:1730284910
Name:SUHEY, PAUL V (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:V
Last Name:SUHEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3266
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32085-3266
Mailing Address - Country:US
Mailing Address - Phone:904-819-4602
Mailing Address - Fax:
Practice Address - Street 1:351 TOWN PLAZA AVENUE
Practice Address - Street 2:201
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32086
Practice Address - Country:US
Practice Address - Phone:904-819-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005615L207X00000X, 207XX0005X
FLOS5823207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016599810005Medicaid
PA0016599810005Medicaid
PAE30470Medicare UPIN
PA00371YSZMedicare PIN