Individual
MRS. SUSAN B MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
783 W OSCEOLA ST, CLERMONT, FL 34711
(315) 516-0027
Mailing address
783 W OSCEOLA ST, CLERMONT, FL 34711-2127
(315) 516-0027
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10-302801
NY
Other
Enumeration date
11/19/2010
Last updated
04/24/2015
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