Provider Demographics
NPI:1366564882
Name:SUOMELA, DAVID (DOM, AP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SUOMELA
Suffix:
Gender:M
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 SE 15TH TER
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4428
Mailing Address - Country:US
Mailing Address - Phone:954-234-6005
Mailing Address - Fax:
Practice Address - Street 1:225 SE 15TH TER
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4428
Practice Address - Country:US
Practice Address - Phone:954-234-6005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2326171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP2326OtherSTATE LICENSE