Provider Demographics
NPI:1972513489
Name:MCGINTY, SUSANNE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:
Last Name:MCGINTY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4741 AINSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5454
Mailing Address - Country:US
Mailing Address - Phone:609-405-1681
Mailing Address - Fax:
Practice Address - Street 1:726 S TAMPA AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3646
Practice Address - Country:US
Practice Address - Phone:407-246-1788
Practice Address - Fax:407-246-8466
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9263776363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000269100Medicaid