Provider Demographics
NPI:1780912063
Name:STEWART, SUZANNE MARIE (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARIE
Last Name:STEWART
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 1:6724 SW 139TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1376
Mailing Address - Country:US
Mailing Address - Phone:305-270-2229
Mailing Address - Fax:305-270-2284
Practice Address - Street 1:9085 SW 87TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2309
Practice Address - Country:US
Practice Address - Phone:305-270-2229
Practice Address - Fax:305-270-2284
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME821332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry