Active NPI
Daniel Su
- Internal Medicine Physician
- Trinity, FL
National Provider Identifier
1497498984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- TRN35009
- Practice address
- 9330 Sr-54 East
Trinity, FL 34655 - Phone
- (727) 834-4000
- NPI assigned
- Apr 14, 2022
- Last updated
- Aug 16, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TRN35009 | FL | |
| Internal Medicine Physician | 207R00000X | TRN35009 | FL | Primary |
Addresses
Primary practice location
9330 Sr-54 East
Trinity, FL 34655
Mailing address
9330 Sr-54 East
Trinity, FL 34655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN35009 | FL | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660608000000",
"number": "1497498984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9330 SR-54 EAST",
"city": "TRINITY",
"state": "FL",
"postal_code": "34655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9330 SR-54 EAST",
"city": "TRINITY",
"state": "FL",
"postal_code": "34655",
"telephone_number": "727-834-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-14",
"last_updated": "2022-08-16",
"certification_date": "2022-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "TRN35009",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "TRN35009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trinity, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.