Bertollo, Suzanne M.
Bertollo, Suzanne M. is an individual health care provider with primary practice located at 777 Glades Rd # Bc71 , Boca Raton FL 33431-6424. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine. Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine is her primary health care specialty. Bertollo, Suzanne M. can be contacted via phone (561) 297-3622.Contact Information
Primary practice address
777 Glades Rd # Bc71
Boca Raton FL 33431-6424
Phone: (561) 297-3622
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | ME144621 | Florida |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 9700023 | North Carolina |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 30296 | South Carolina |
| Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine | 2083P0901X | ME144621 | Florida |
| Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine | 2083P0901X | 30296 | South Carolina |
Profile Details
| NPI number | 1871542902 |
|---|---|
| LBN Legal business name | Bertollo, Suzanne M. |
| Credentials | M.D., MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2006 |
| Last updated | Jun 28th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871542902 | NPPES |
| South Carolina | Other | AA22522353 | MEDICARE PTAN |
| South Carolina | MEDICAID | N00023 | MEDICARE PTAN |
| South Carolina | MEDICAID | 79-10976 | MEDICARE PTAN |
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