Healthcare Provider Details

I. General information

NPI: 1972513489
Provider Name (Legal Business Name): SUSANNE MCGINTY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 S TAMPA AVE
ORLANDO FL
32805-3646
US

IV. Provider business mailing address

4741 AINSWORTH DR
ORLANDO FL
32837-5454
US

V. Phone/Fax

Practice location:
  • Phone: 407-246-1788
  • Fax: 407-246-8466
Mailing address:
  • Phone: 609-405-1681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number9263776
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: