Provider Demographics
NPI:1285753822
Name:EXPOSITO, SUSAN (DC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:EXPOSITO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 COLLINS AVE
Mailing Address - Street 2:7K
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2754
Mailing Address - Country:US
Mailing Address - Phone:786-372-3950
Mailing Address - Fax:
Practice Address - Street 1:235 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3713
Practice Address - Country:US
Practice Address - Phone:786-372-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX06447111N00000X
FLCH6400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU30546Medicare UPIN
NYX52341Medicare ID - Type Unspecified