Healthcare Provider Details

I. General information

NPI: 1396830188
Provider Name (Legal Business Name): SUSAN A SZAROLETA RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 REGENCY COURT SUITE 204
TOLEDO OH
43623
US

IV. Provider business mailing address

2000 REGENCY COURT SUITE 204
TOLEDO OH
43623
US

V. Phone/Fax

Practice location:
  • Phone: 419-720-2008
  • Fax: 419-720-2009
Mailing address:
  • Phone: 419-720-2008
  • Fax: 419-720-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0121X
TaxonomyPlastic Surgery Registered Nurse
License NumberRN 180858
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: