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NPI Code Detail

MEDICARE: DR. SUSAN FAYE MULERO M.D.

MEDICARE: DR. SUSAN FAYE MULERO M.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
1207Q00000XFamily Medicine PhysicianME 7229FL

General Provider Information

NPI Number : 1811921398
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN FAYE MULERO M.D.
Provider Business Mailing Address
First Line : 220 GRAND REGENCY BLVD
Second Line :
City : BRANDON
State : FL
Zip : 33510-3935
Country : US
Telephone Number : 813-827-9798
Fax Number :
Provider Business Practice Location Address
First Line : 220 GRAND REGENCY BLVD
Second Line :
City : BRANDON
State : FL
Zip : 33510-3935
Country : US
Telephone Number : 813-827-9798
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 10/13/2010

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