SUKSANONG AND SUKSANONG MDS PA
Osteopathic Medicine in Saint Petersburg, FL

License number
Florida ME31666
Category
Osteopathic Medicine
Type
Infectious Disease
Owner
Name: MINGQUAN SUKSANONG MD
Title: VP
Phone: (727) 823-7224
Address
Address 2
1752 Mlk Jr St N, Saint Petersburg, FL 33704
PO Box 1945, Palm Harbor, FL 34682
National Provider ID: 1528249687
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Suksanong And Suksanong MD Pa

1752 Dr Martin Luther King Jr St N, Saint Petersburg, FL 33704

Categories:
Physicians & Surgeons
Phone:
(727) 823-7224 (Phone)

SUKSANONG AND SUKSANONG, M.D.'S, PA

Saint Petersburg, FL

Status:
Inactive
Inactive reason:
Cancel Adm Diss/rev
Registration:
Sep 1, 1981
Inactive since:
Oct 10, 2006
Addresses:
1752-Dr Mlk Jr St N, Saint Petersburg, FL 33704 (Physical)
1752 Dr Martin Luther King Jr St N, Saint Petersburg, FL 33704
State ID:
F43316
Business type:
Florida Profit Corporation
S:
Thawatchai Suksanong (President), 1752-Dr Mlk Jr St N, Saint Petersburg, FL 33704 (Physical),Mingquan Suksanong (Director, Vice President), 1752-Dr Mlk Jr St N, Saint Petersburg, FL 33704 (Physical),Suksanong, Mingquan, Dr, 1752-Dr Mlk Jr St N, Saint Petersburg, FL 33704 (Physical)
Agent:
Suksanong, Mingquan,1752-Dr Mlk Jr St N, Saint Petersburg, FL 33704 (Physical)
EIN:
59-2120716

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