Mattox, Susan Elizabeth
Mattox, Susan Elizabeth is an sole proprietor health care provider with primary practice located at 434 Grove Ave , Winter Park FL 32789-3651. She recently has only one registered license in Other Service Providers / Midwife, which is considered as her primary health care specialty. Mattox, Susan Elizabeth can be contacted via phone (407) 644-5567.Contact Information
Primary practice address
434 Grove Ave
Winter Park FL 32789-3651
Phone: (407) 644-5567
Fax: (407) 644-4975
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Midwife | 176B00000X | MW183 | Florida |
Profile Details
| NPI number | 1881785897 |
|---|---|
| LBN Legal business name | Mattox, Susan Elizabeth |
| Credentials | Licensed Midwife (LM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Jan 12th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881785897 | NPPES |
| Florida | MEDICAID | 340552400 | |
| Florida | Other | Y00U1 |
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