Healthcare Provider Details

I. General information

NPI: 1114843935
Provider Name (Legal Business Name): SUSAN A DEEB ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 SW 106TH TER
DAVIE FL
33324-6313
US

IV. Provider business mailing address

2330 SW 106TH TER
DAVIE FL
33324-6313
US

V. Phone/Fax

Practice location:
  • Phone: 954-665-4075
  • Fax:
Mailing address:
  • Phone: 954-665-4075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9240099
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: