Provider Demographics
NPI:1427441625
Name:SUFKA, AMY LOU (MS, CGC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LOU
Last Name:SUFKA
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 EXECUTIVE CENTER DR W STE 206
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2472
Mailing Address - Country:US
Mailing Address - Phone:800-975-4819
Mailing Address - Fax:760-203-1194
Practice Address - Street 1:877 EXECUTIVE CENTER DR W STE 206
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2472
Practice Address - Country:US
Practice Address - Phone:760-904-4904
Practice Address - Fax:760-203-1194
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS