Provider Information for 1760951974
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Ms. SUZANNE KATIFEDENIOS
Sex: Female
NPI: 1760951974
Last Updated: 2022-01-31
Certification Date: 2022-01-31
Certification Date: 2022-01-31
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1760951974 | ||||||||||||
| Enumeration Date | 2018-11-16 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 8800 49TH ST N STE 106 PINELLAS PARK, FL 33782-5332 United States Phone: 727-544-0044 | Fax: | ||||||||||||
| Primary Practice Address | 2792 PEACHTREE CIR CLEARWATER, FL 33761-3838 United States Phone: 484-767-9966 | Fax: | ||||||||||||
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