MEDICARE: SUSEL SANCHEZ FROMETA APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	APRN11027863	FL
2	363LF0000X	Family Nurse Practitioner	APRN11027863	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194502518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSEL SANCHEZ FROMETA APRN

Provider Business Mailing Address
First Line	:	9500 S DADELAND BLVD STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2866
Country	:	US
Telephone Number	:	786-530-3820
Fax Number	:	350-675-3378

Provider Business Practice Location Address
First Line	:	7270 W BOYNTON BEACH BLVD STE B1
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3805
Country	:	US
Telephone Number	:	561-738-5772
Fax Number	:	561-738-0096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	08/27/2025

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