Susko, Keith S.

Susko, Keith S. is an individual health care provider with primary practice located at 4977 Royal Gulf Cir , Fort Myers FL 33966-7006. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Susko, Keith S. can be contacted via phone (239) 226-0077.

Contact Information

Primary practice address
4977 Royal Gulf Cir Fort Myers FL 33966-7006
Phone: (239) 226-0077
Fax: (239) 489-0077
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X ME85368 Florida
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X ME85368 Florida

Profile Details

NPI number 1275595159
LBN Legal business name Susko, Keith S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Sep 26th, 2023 - about 2 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 1275595159 NPPES
Florida Other 17033 BCBS
Florida Other 17033X BCBS
Florida MEDICAID 2658666-00 BCBS

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