Provider Demographics
NPI:1124486584
Name:DILLEY, SUZANNE (CSFA)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:DILLEY
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4769 NW 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-7845
Mailing Address - Country:US
Mailing Address - Phone:352-789-3460
Mailing Address - Fax:
Practice Address - Street 1:4769 NW 46TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-7845
Practice Address - Country:US
Practice Address - Phone:352-789-3460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical