Healthcare Provider Details

I. General information

NPI: 1407992597
Provider Name (Legal Business Name): SUSAN ZITO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13425 BELCHER RD S
LARGO FL
33771
US

IV. Provider business mailing address

13425 BELCHER RD S
LARGO FL
33771-4009
US

V. Phone/Fax

Practice location:
  • Phone: 727-223-9610
  • Fax: 727-303-3193
Mailing address:
  • Phone: 727-223-9610
  • Fax: 727-303-3193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number9016
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberOS9016
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: