Susan Mary Fitzgerald, MA CCCSLP
Individual provider Active NPI Speech-Language Pathologist · New Port Richey, FL
NPI 1215083233 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1215083233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SA2452 (FL)
- Practice address
- 7901 Yucca Dr
New Port Richey, FL 34653 - Phone
- (727) 845-4435
- Fax
- (727) 841-0190
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250411001001 | FL | Practitioner - Qualified Speech Language Pathologist | 9638693617 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA2452 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Living Rehabilitation Inc | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA2452 | FL | Yes |
Addresses
Primary practice location
7901 Yucca Dr
New Port Richey, FL 34653
Mailing address
7901 Yucca Dr
New Port Richey, FL 34653
Phone (727) 845-4435
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SA2452 | Other | FL | SLP LICENSE |
Other names
- Mrs. Susan Fitzgerald Miller
Other providers in New Port Richey, FL
- Rachel Kern Finnegan
- Nicole Finney
- Misty Fischer
- Alexis Fitch
- Stephen Gerard Fitzgerald
- FL Medical Center of New Port Richey PA
- Kailyn Flanders
- Tara Kaitlyn Fleming
- Jane Erika Fletcher-Ortman
- Flex Rehab LLC
All providers in New Port Richey, FL · Speech-Language Pathologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.