Healthcare Provider Details

I. General information

NPI: 1730594904
Provider Name (Legal Business Name): SUSAN M. POSADA, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16614 N DALE MABRY HWY
TAMPA FL
33618-1400
US

IV. Provider business mailing address

1001 SYLVIA LN
TAMPA FL
33613-2004
US

V. Phone/Fax

Practice location:
  • Phone: 813-215-5558
  • Fax:
Mailing address:
  • Phone: 813-215-5558
  • Fax: 813-354-4769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT1837
License Number StateFL

VIII. Authorized Official

Name: DR. SUSAN MORHARD POSADA
Title or Position: PRESIDENT
Credential: PHD
Phone: 813-215-5558