Individual
SUSAN MINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
12902 USF MAGNOLIA DR, MDC 44, TAMPA, FL 33612-9416
(813) 745-1600
(813) 979-7287
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
OS6353
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250002700
—
FL
01
—
57350
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/19/2006
Last updated
09/28/2010
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