Provider Demographics
NPI:1932716701
Name:ALLGEYER, SUSAN ANN (AP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:ALLGEYER
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 PINETREE DR STE 9
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4429
Mailing Address - Country:US
Mailing Address - Phone:321-960-6959
Mailing Address - Fax:
Practice Address - Street 1:1300 PINETREE DR STE 9
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4429
Practice Address - Country:US
Practice Address - Phone:321-960-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3298364SH1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH1100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHolistic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64OtherN/A