Susan Elizabeth Fiello

Individual provider Active NPI Attendant Care Provider · Edgewater, FL

NPI 1376837468 · NPPES record last updated Jun 6, 2011

Key facts

NPI
1376837468
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
License
6906318 (FL)
Practice address
1721 Victory Palm Dr
Edgewater, FL 32132-3114
Phone
(386) 402-4945
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6906318FLMDAttendant Care Provider

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X 6906318 FL Yes

Addresses

Primary practice location

1721 Victory Palm Dr
Edgewater, FL 32132-3114

Mailing address

1721 Victory Palm Dr
Edgewater, FL 32132-3114
Phone (386) 402-4945

Other providers in Edgewater, FL

All providers in Edgewater, FL · Attendant Care Provider in Florida

Sources for this page

Verify at the official NPI Registry.