Individual
MRS. SUSAN CAROL JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2629 W SR 434, LONGWOOD, FL 32779-4878
(407) 774-1716
(407) 774-9527
Mailing address
2629 W. SR 434, LONGWOOD, FL 32779
(407) 869-8214
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT0002774
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y3394
BC/BS
FL
Enumeration date
08/30/2006
Last updated
03/11/2010
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