Provider Demographics
NPI:1053383703
Name:MAY, SUSANA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SUSANA
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:MD, MPH
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 739
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-0739
Mailing Address - Country:US
Mailing Address - Phone:305-852-7490
Mailing Address - Fax:305-743-5383
Practice Address - Street 1:5701 OVERSEAS HWY
Practice Address - Street 2:STE 17
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2784
Practice Address - Country:US
Practice Address - Phone:305-743-5383
Practice Address - Fax:305-743-2253
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62312207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA92788Medicare UPIN
FL18085Medicare ID - Type Unspecified