| Mrs Suzanne Korum, ARNP-BC | |
| 
					20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164-7528  | |
| (386) 586-7005 | |
| (844) 867-3940 | 
| Full Name | Mrs Suzanne Korum | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Adult Health | 
| Location | 20 Cypress Point Pkwy Ste A, Palm Coast, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1093149569 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | ARNP1853762 (Florida) | Primary | 
| Entity Name | Palm Harbor Family Practice And Walk-in Clinic, P.a | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1831311810 PECOS PAC ID: 9133108541 Enrollment ID: O20040719000940  | 
| Entity Name | Conviva Medical Center Management, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1649324278 PECOS PAC ID: 4284717422 Enrollment ID: O20080212000415  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mrs Suzanne Korum, ARNP-BC 6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168 Ph: (305) 500-2000  | Mrs Suzanne Korum, ARNP-BC 20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164-7528 Ph: (386) 586-7005  | 
Jennifer A Schroeder, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 61 Memorial Medical Pkwy Ste 2812, Palm Coast, FL 32164 Phone: 386-586-1860 Fax: 386-586-1861  | |
Vivian Del Carmen Medina, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14 Office Park Dr Ste 6, Palm Coast, FL 32137 Phone: 407-299-7333  | |
Jennifer Marie Agosto, ACNPC-AG Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 60 Piedmont Dr, Palm Coast, FL 32164 Phone: 305-588-0373  | |
Amanda Vera, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 61 Memorial Medical Pkwy Ste 2815, Palm Coast, FL 32164 Phone: 386-586-1810 Fax: 386-586-1811  | |
Traci Serrano, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 61 Memorial Medical Pkwy Ste 3816, Palm Coast, FL 32164 Phone: 386-586-1720  | |
Mrs. Venus M. Valliere, ARNP BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164 Phone: 386-586-7005 Fax: 844-867-3940  |