Provider Demographics
NPI:1174545735
Name:SUGGS, RONNIE EUGENE (DPM)
Entity type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:EUGENE
Last Name:SUGGS
Suffix:
Gender:M
Credentials:DPM
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 593188
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32859-3188
Mailing Address - Country:US
Mailing Address - Phone:407-240-0002
Mailing Address - Fax:407-240-0088
Practice Address - Street 1:6922 SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:BELLE ISLE
Practice Address - State:FL
Practice Address - Zip Code:32812-3713
Practice Address - Country:US
Practice Address - Phone:407-240-0002
Practice Address - Fax:407-240-0088
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2451213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390230700Medicaid
480021182OtherRAILROAD MEDICARE
593349883OtherHUMANA
T61117Medicare UPIN
FL40317Medicare ID - Type Unspecified