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General NPI Number Information
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NPI Number | 1467704031
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Entity Type | Individual
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Provider Name | SUSAN NEAL ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 550 E DIXIE AVE
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City | LEESBURG
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State | FL
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Zip | 34748-5925
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Country | US
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Telephone | 352-323-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 600 E DIXIE AVE ATTN: EDNA PEART, REIMBURSEMENT
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City | LEESBURG
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State | FL
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Zip | 34748-5925
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Country | US
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Telephone | 352-323-4267
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP1063272
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License Number State | FL
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