Provider Demographics
NPI:1699800532
Name:PERKINS, SUSAN NATHANSON (DC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:NATHANSON
Last Name:PERKINS
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 1:780 US HIGHWAY 1
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-1660
Mailing Address - Country:US
Mailing Address - Phone:772-567-7777
Mailing Address - Fax:772-778-9382
Practice Address - Street 1:780 US HIGHWAY 1
Practice Address - Street 2:SUITE 201
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32962-1660
Practice Address - Country:US
Practice Address - Phone:772-567-7777
Practice Address - Fax:772-778-9382
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4035ZMedicare ID - Type Unspecified
FLT56020Medicare UPIN