1578757407 NPI number — MS. SUZETTE EDWIN CHAPMAN L.M.T.

Table of content: MS. SUZETTE EDWIN CHAPMAN L.M.T. (NPI 1578757407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578757407 NPI number — MS. SUZETTE EDWIN CHAPMAN L.M.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAPMAN
Provider First Name:
SUZETTE
Provider Middle Name:
EDWIN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.M.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHAPMAN
Provider Other First Name:
SUZETTE
Provider Other Middle Name:
EDWIN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICENSE MASSAGE THER
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1578757407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
164 NE 167TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33162-3403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-945-7246
Provider Business Mailing Address Fax Number:
305-945-7246

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
164 NE 167TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33162-3403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-945-7246
Provider Business Practice Location Address Fax Number:
305-945-7246
Provider Enumeration Date:
09/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA32691 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MA32691 . This is a "MASSAGE THERAPY" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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