Provider Demographics
NPI:1902109143
Name:SUSAN C SCHUSSLER
Entity Type:Organization
Organization Name:SUSAN C SCHUSSLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHUSSLER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, RN, CDE
Authorized Official - Phone:941-358-6568
Mailing Address - Street 1:4431 WINSTON LN S
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-3210
Mailing Address - Country:US
Mailing Address - Phone:941-358-6568
Mailing Address - Fax:941-355-0685
Practice Address - Street 1:4431 WINSTON LN S
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-3210
Practice Address - Country:US
Practice Address - Phone:941-358-6568
Practice Address - Fax:941-355-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4731133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty