MEDICARE: SUSAN ELIZABETH MCLEAN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	372500000X	Chore Provider
3	372600000X	Adult Companion
4	373H00000X	Day Training/Habilitation Specialist
5	3747A0650X	Attendant Care Provider
6	3747P1801X	Personal Care Attendant
7	374U00000X	Home Health Aide
8	376J00000X	Homemaker
9	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1669791810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN ELIZABETH MCLEAN

Provider Business Mailing Address
First Line	:	18946 TWINBERRY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3418
Country	:	US
Telephone Number	:	813-981-8187
Fax Number	:

Provider Business Practice Location Address
First Line	:	18946 TWINBERRY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3418
Country	:	US
Telephone Number	:	813-981-8187
Fax Number	:

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

Provider Enumeration Date	:	05/27/2010
Last Update Date	:	05/27/2010

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