Susan C Jannou
Individual provider Active NPI Podiatrist · Nokomis, FL
NPI 1962461970 · NPPES record last updated Apr 29, 2010
Key facts
- NPI
- 1962461970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- PO 2384 (FL)
- Practice address
- 2420 Tamiami TRL N
Suite a
Nokomis, FL 34275-3475 - Phone
- (941) 966-1777
- Fax
- (941) 966-8628
- NPI assigned
- Mar 20, 2006
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO 2384 | FL | MD | Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO 2384 | FL | Yes |
Addresses
Primary practice location
2420 Tamiami TRL N
Suite a
Nokomis, FL 34275-3475
Mailing address
2420 Tamiami TRL N
Suite a
Nokomis, FL 34275-3475
Phone (941) 966-1777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6201051 | Other | FL | GHI |
| 82277789 | Other | FL | AARP |
| 480028734 | Other | RAIL ROAD MEDICARE | |
| 65353 | Other | FL | BLUECROSS BLUESHIELD |
| 650951406 | Other | FL | CHAMPUS |
Other providers in Nokomis, FL
- Insight Behavioral Health & Addiction Solutions Inc
- Insight Behavioral Health & Addiction Solutions, Inc.
- Instride Therapy, Inc.
- Interpersonal Paracletic Counseling Services Siesta Key Nature
- John Dempsey Ivey
- Jennifer Lynn Jaworski
- Christine Lynn Johnson
- Ciara Johnson
- Justin Ross Wasserman MD PL
- Dorothy J Kellum
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.