MEDICARE: DR. SUSAN NOREEN FROST PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY7051	FL

General Provider Information

NPI Number	:	1306896949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN NOREEN FROST PSY.D.

Provider Business Mailing Address
First Line	:	570 SUNSET LN
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32952-5301
Country	:	US
Telephone Number	:	321-454-6373
Fax Number	:

Provider Business Practice Location Address
First Line	:	1980 N ATLANTIC AVE
Second Line	:	SUITE 515
City	:	COCOA BEACH
State	:	FL
Zip	:	32931-5213
Country	:	US
Telephone Number	:	321-961-2833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/21/2022

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