Organization
SUSGEN HEALTH NETWORK INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN B. PEACOCK M.S.R.D (OWNER)
(561) 758-1734
Entity
Organization
Contact information
Practice address
100 WATERWAY DR S APT 203, LANTANA, FL 33462-1827
(561) 758-1734
Mailing address
100 WATERWAY DR S APT 203, LANTANA, FL 33462-1827
(561) 758-1734
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND3521
FL
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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