Pekarek, Suzanne Nicole

Pekarek, Suzanne Nicole is an individual health care provider with primary practice located at 123 Truxton Ave , Fort Walton Beach FL 32547-2460. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Pekarek, Suzanne Nicole can be contacted via phone (850) 863-1530.

Contact Information

Primary practice address
123 Truxton Ave Fort Walton Beach FL 32547-2460
Phone: (850) 863-1530
Fax: (850) 863-5548
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1558559963
LBN Legal business name Pekarek, Suzanne Nicole
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2007
Last updated Oct 10th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558559963 NPPES
Florida MEDICAID APPLICATION

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