Provider Demographics
NPI:1215800800
Name:BURNEO, SUSI (RCSWI)
Entity type:Individual
Prefix:
First Name:SUSI
Middle Name:
Last Name:BURNEO
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 NW 135TH WAY UNIT 302
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325-7700
Mailing Address - Country:US
Mailing Address - Phone:954-868-8500
Mailing Address - Fax:
Practice Address - Street 1:850 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5718
Practice Address - Country:US
Practice Address - Phone:954-868-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist