Individual
SUSAN C JANNOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2420 TAMIAMI TRL N, SUITE A, NOKOMIS, FL 34275-3475
(941) 966-1777
(941) 966-8628
Mailing address
2420 TAMIAMI TRL N, SUITE A, NOKOMIS, FL 34275-3475
(941) 966-1777
(941) 966-8628
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO 2384
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480028734
RAIL ROAD MEDICARE
—
01
—
6201051
GHI
FL
01
—
650951406
CHAMPUS
FL
01
—
65353
BLUECROSS BLUESHIELD
FL
01
—
82277789
AARP
FL
Enumeration date
03/20/2006
Last updated
04/29/2010
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