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General NPI Number Information
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NPI Number | 1366500365
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Entity Type | Individual
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Provider Name | SUSAN L O'NEAL LMT
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1435 HOWELL BRANCH RD SUITE E.
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City | WINTER PARK
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State | FL
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Zip | 32789-1157
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Country | US
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Telephone | 407-622-6244
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 CAMBRIDGE RD
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City | MAITLAND
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State | FL
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Zip | 32751-3563
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Country | US
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Telephone | 407-421-7859
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Fax | 407-622-6244
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA33819
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License Number State | FL
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