Issam D Soussou, MD
in Sarasota, FL. Individual provider (NPI-1).
NPI number1104884584
StatusActive
Last updated in NPPESMay 7, 2020
Details
- NPI
- 1104884584
- Entity type
- Individual (NPI-1)
- Name
- Issam D Soussou
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 3, 2006
- Certification date
- May 7, 2020
- Last updated
- May 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0129X | ME35636 | FL | Yes |
Practice location
3333 Cattlemen RdSuite 206
Sarasota, FL 34232-6056
Phone 941-341-0042 · Fax 941-342-3432
Mailing address
3333 Cattlemen RdSuite 206
Sarasota, FL 34232-6056
Phone 941-341-0042 · Fax 941-342-3432
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