Susanne M Cubberley

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

License

151134962 Issued in FL

Practice address

11972 Orange Blossom Dr
Seminole, FL 33772-3443

Phone

(727) 385-8046

NPI assigned

Oct 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Enduring Life Services LLC

  • Assisted Living Facility
  • Seminole, FL
  • NPI 1568979466
  NPD (past) Authorized official

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1538679378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11972 ORANGE BLOSSOM DR",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337723443",
            "telephone_number": "727-385-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11972 ORANGE BLOSSOM DR",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337723443",
            "telephone_number": "727-385-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBBERLEY",
        "first_name": "SUSANNE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "FL",
            "license": "151134962",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN33667152",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015342000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Marelis Creixell Leon
• Kaci Ann Crook, MA, LMHC, NCC
• Summer Renee Cross, APRN
• Crown Care Medical Products, Inc.
• Aileen Cruz Lezama, DMD
• Kathleen A Cullen, MD
• Kelli Culler, PHARMD
• Whelan W Culley III, MD
• Caitlin Cunha
• Sheyla Michele de Souza Cunha, APRN, FNP-C,PMHNP-BC

• Nursing Home Administrator in Seminole, FL
• Providers in Seminole, FL by specialty
• Nursing Home Administrator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.