Individual
DR. SUSAN NESSELROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3600 WASHINGTON ST, HOLLYWOOD, FL 33021-8216
(954) 518-5300
Mailing address
1615 NE 5TH CT, FT LAUDERDALE, FL 33301-1329
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME 77770
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267782200
—
FL
01
—
U1350
MEDICARE CORE
FL
Enumeration date
09/23/2005
Last updated
03/17/2021
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