MEDICARE: SUSAN A TEASLEY

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	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1992669972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN A TEASLEY

Provider Business Mailing Address
First Line	:	1400 VILLAGE SQUARE BLVD # 3-512
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-1250
Country	:	US
Telephone Number	:	850-655-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 MENDOZA AVE
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32304-1319
Country	:	US
Telephone Number	:	850-655-1400
Fax Number	:

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

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ SUSAN A TEASLEY ” Practice Location

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