Suksanong, Mingquan Tongbhakdee

Suksanong, Mingquan Tongbhakdee is an individual health care provider with primary practice located at 1752 Mlk Jr St N , St Petersburg FL 33704-4206. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Suksanong, Mingquan Tongbhakdee can be contacted via phone (727) 823-7224.

Contact Information

Primary practice address
1752 Mlk Jr St N St Petersburg FL 33704-4206
Phone: (727) 823-7224
Fax: (727) 489-9486
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X ME0031666 Florida

Profile Details

NPI number 1790746840
LBN Legal business name Suksanong, Mingquan Tongbhakdee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated May 1st, 2012 - about 14 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 1790746840 NPPES
Florida Other 52999 BCBS
Florida Other P00883306 BCBS
Florida Other 160184600 BCBS
Florida MEDICAID 059830500 BCBS

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