Provider Demographics
NPI:1801942370
Name:SUSAN PATRICK RODELL M D P A
Entity type:Organization
Organization Name:SUSAN PATRICK RODELL M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:RODELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-750-3520
Mailing Address - Street 1:801 MEADOWS RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2346
Mailing Address - Country:US
Mailing Address - Phone:561-750-3520
Mailing Address - Fax:561-750-8009
Practice Address - Street 1:801 MEADOWS RD
Practice Address - Street 2:SUITE 114
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-750-3520
Practice Address - Fax:561-750-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty