Provider Demographics
NPI:1124164413
Name:MILLER, SUSAN (OTR, CHT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:NORIEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2801 NE 40TH ST
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-8457
Mailing Address - Country:US
Mailing Address - Phone:954-881-0890
Mailing Address - Fax:954-567-2619
Practice Address - Street 1:5800 COLONIAL DR
Practice Address - Street 2:400
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5682
Practice Address - Country:US
Practice Address - Phone:954-881-0890
Practice Address - Fax:954-979-3608
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT2755225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand