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Dr. Jacob Sudduth, MD
Student in an Organized Health Care Education/Training Program in Port St Lucie, Florida
NPI 1821790593

Jacob Sudduth is a Student in an Organized Health Care Education/Training Program based in St Petersburg, FL. Jacob Sudduth practices in Port St Lucie, FL and has the professional credentials of MD. The NPI Number for Jacob Sudduth is 1821790593 and holds a License No. (Florida).

The current practice location address for Jacob Sudduth is 1800 Se Tiffany Ave, Port St Lucie, FL and can be reached out via phone at 772-335-4000.

Location: 1800 Se Tiffany Ave, Port St Lucie, FL, 33710-1629
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821790593
Provider Name
Jacob Sudduth
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1800 Se Tiffany Ave, Port St Lucie, FL, 33710-1629
Phone Number
772-335-4000
Fax Number
Provider Enumeration Date
03/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1800 Se Tiffany Ave
City
Port St Lucie
State
Florida
Zip
34952-7521
Phone Number
772-335-4000
Fax Number
person
Provider Business Mailing Address Details
Address
1800 Se Tiffany Ave
City
Port St Lucie
State
Florida
Zip
34952-7521
Phone Number
772-335-4000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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