Healthcare Provider Details

I. General information

NPI: 1609175215
Provider Name (Legal Business Name): SUZANNE ELIZABETH CHEAS MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3335 N UNIVERSITY DR SUITE 5
HOLLYWOOD FL
33024-2200
US

IV. Provider business mailing address

2007 SW 102ND TER
MIRAMAR FL
33025-1777
US

V. Phone/Fax

Practice location:
  • Phone: 954-442-9422
  • Fax: 954-442-9150
Mailing address:
  • Phone: 954-559-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14551
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: