DR. SUZANNE T ICELY (NPI# 1720063613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720063613 |
| Entity Type | Individual |
| Full Name | DR. SUZANNE T ICELY |
| Credential | M.D. |
| Practice Address |
6450 38th Ave N Suite 200 St Petersburg FL 33710-1645 |
| Practice Telephone | 7273446060 |
| Practice Fax Number | 7273475586 |
| Mailing Telephone | 7273446060 |
| Mailing Fax Number | 7273475586 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2015-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | ME0071624 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 255805000 | 05 |
| Street Address |
6450 38TH AVE N SUITE 200 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33710-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215932249 | Narinder Trehan | Internal Medicine | 6450 38th Ave N, Suite 400, St Petersburg, FL 33710-1645 | 2005-06-16 |
| 1295199172 | Coastal Foot & Ankle Specialists LLC | Podiatrist | 6450 38th Ave N, Suite 310, St Petersburg, FL 33710-1645 | 2016-04-07 |
| 1013399427 | Women's Health Care St. Pete | Clinic/Center | 6450 38th Ave N, Suite 320, St Petersburg, FL 33710-1645 | 2015-06-22 |
| 1245649474 | Hadjer Bounama | Family Medicine | 6450 38th Ave N, St Petersburg, FL 33710-1645 | 2014-08-13 |
| 1851633085 | Heather Dawn Zelna | Podiatrist | 6450 38th Ave N, Suite 310, St Petersburg, FL 33710-1645 | 2013-03-26 |
| 1376885517 | Brendon Taylor Zelna | Podiatrist | 6450 38th Ave N, Suite 310, St Petersburg, FL 33710-1645 | 2013-03-26 |
| 1508155904 | Jenny E Michael | Obstetrics & Gynecology | 6450 38th Ave N, Siute 200, St Petersburg, FL 33710-1645 | 2011-04-06 |
| 1790091817 | Stacy Dannielle Chase | Family Medicine | 6450 38th Ave N, Suite 400, St Petersburg, FL 33710-1645 | 2010-08-26 |
| 1376719625 | Michelle M Arrieta-gonzalez | Internal Medicine | 6450 38th Ave N, St Petersburg, FL 33710-1645 | 2008-05-07 |
| 1528239068 | Medical Associates of Central Pinellas | Clinic/Center | 6450 38th Ave N, Suite #350, St Petersburg, FL 33710-1645 | 2008-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615812 | Bay Vision Inc | Optometrist | 6951 22nd Ave North, St. Petersburg, FL 33710 | 2020-10-05 |
| 1821566845 | Harish J. Patel, Md | Non-Pharmacy Dispensing Site | 6449 38th Avenue North, Suite B3, Saint Petersburg, FL 33710 | 2018-11-07 |
| 1659860708 | Lydia M Gomez | Physical Therapist | 6775 Crosswinds Dr. N, Saint Petersburg, FL 33710 | 2018-05-04 |
| 1619498169 | Tiffiny C Rudkin | Massage Therapist | 3039 - 49th St. N., St. Petersburg, FL 33710 | 2017-07-05 |
| 1114456480 | Roberto Macedo Dentistry LLC | Dentist | 7801 38th Ave North, St. Petersburg, FL 33710 | 2017-06-08 |
| 1528429495 | Frank Michael Massotto Jr. | Nurse Practitioner | 3251 66th St. North, St Petersburg, FL 33710 | 2016-03-18 |
| 1235522889 | Toby Weinman Assisted Living Residence | Assisted Living Facility | 240 59th St N, St Petersburg, FL 33710 | 2015-03-06 |
| 1821415951 | Ryan Troup | Physician Assistant | 603 - 7th St. S, Suite 360, Emergency Physicians of Saint Petersburg, Saint Petersburg, FL 33710 | 2014-03-26 |
| 1629491600 | Garett Janes Sears | Psychologist | 1913 Tyrone Blvd, St. Petersburg, FL 33710 | 2014-01-28 |
| 1912331943 | Solimar Jimenez Diaz | Obstetrics & Gynecology | 6450 38th Ave N Ste 200, St Petersburg, FL 33710 | 2013-08-27 |
| Find all providers in zip 33710 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285014514 | Tammy Nguyen | Obstetrics & Gynecology | 5959 Central Ave Ste 103, St Petersburg, FL 33710-8502 | 2015-06-02 |
| 1912331943 | Solimar Jimenez Diaz | Obstetrics & Gynecology | 6450 38th Ave N Ste 200, St Petersburg, FL 33710 | 2013-08-27 |
| 1720384571 | Raphael Guichard | Obstetrics & Gynecology | 625 6th Ave S Ste 350, St Petersburg, FL 33701-4619 | 2011-01-26 |
| 1326210238 | Jennifer Elizabeth Griffin | Obstetrics & Gynecology | 205 Dr, Martin Luther King Jr. St. N., St Petersburg, FL 33701 | 2008-03-31 |
| 1699842062 | Layla R. Townsend | Obstetrics & Gynecology | 625 6th Avenue South, Suite #350, St Petersburg, FL 33701 | 2006-11-29 |
| 1194819524 | Emanuel L Javate | Obstetrics & Gynecology | 6700 Crosswinds Dr No, Suite 200-a, St Petersburg, FL 33710 | 2006-10-02 |
| 1780697870 | Megan Dawn Indermaur | Obstetrics & Gynecology | 2191 9th Ave N Ste 120, St Petersburg, FL 33713-7147 | 2006-08-13 |
| 1669440665 | Donna Hargrove | Obstetrics & Gynecology | 712 16th St N, St Petersburg, FL 33705-1335 | 2006-03-08 |
| 1306822887 | Marilyn W Fudge | Obstetrics & Gynecology | 700 6th St S, St Petersburg, FL 33701-4815 | 2005-12-16 |
| 1043208523 | Molly M Long | Obstetrics & Gynecology | 603 7th St S, Suite 300, St Petersburg, FL 33701-4719 | 2005-10-10 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33710 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.