=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447418249
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSAN C D'ORAZIO DOM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2008
-----------------------------------------------------
Last Update Date | 01/07/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9070 58TH DR E SUITE 102
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34202-6110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-586-8061
-----------------------------------------------------
Fax | 941-306-5170
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9070 58TH DR E SUITE 102
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34202-6110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-586-8061
-----------------------------------------------------
Fax | 941-306-5170
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AP2137
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------