Supportive MD LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

SUPPORTIVE MD LLC

Practice address

11117 Regatta LN
Wellington, FL 33449-7416

Phone

(626) 389-7410

NPI assigned

Sep 2, 2024

Last updated

Sep 2, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sufana A Al Khunaizi, MDNPI 1063686285

Title

MD

Phone

(626) 389-7410

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sufana Al Khunaizi, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • West Palm Beach, FL
  • NPI 1063686285
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725235200000",
    "number": "1427882356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11117 REGATTA LN",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334497416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11117 REGATTA LN",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334497416",
            "telephone_number": "626-389-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "AL KHUNAIZI",
        "authorized_official_first_name": "SUFANA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "626-389-7410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Suramed Health Center, PA (Suramed Health Center PA Palomino)
• Surgery Center at Wellington
• Surgical Arts Pavilion LLC
• Sweet Speech Therapy Corp
• Synergy Family Care LLC

• Community Health Clinic/Center in Wellington, FL
• Providers in Wellington, FL by specialty
• Community Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.