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NPI Code Detail

MEDICARE: SUZY DESIO LMHC

MEDICARE:   SUZY  DESIO  LMHC
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
1101YM0800XMental Health CounselorMH3939FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122190000OTHERFLMAGELLAN
2Z8102OTHERFLBLUE CROSS

General Provider Information

NPI Number : 1912916719
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZY DESIO LMHC
Provider Business Mailing Address
First Line : 2470 LEMON AVE
Second Line :
City : ENGLEWOOD
State : FL
Zip : 34223-6459
Country : US
Telephone Number : 941-639-8300
Fax Number : 941-639-6831
Provider Business Practice Location Address
First Line : 1700 EDUCATION AVE
Second Line :
City : PUNTA GORDA
State : FL
Zip : 33950-6222
Country : US
Telephone Number : 941-639-8300
Fax Number : 941-639-6831
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 07/08/2007

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Directions to “ SUZY DESIO LMHC” Practice Location

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