Provider Demographics
NPI:1144472184
Name:SCHINSTINE, SUSAN KELLY
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KELLY
Last Name:SCHINSTINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2259 PALOMA ST
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-1216
Mailing Address - Country:US
Mailing Address - Phone:850-582-6674
Mailing Address - Fax:850-939-5221
Practice Address - Street 1:151 MARY ESTHER BLVD STE 309B
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1974
Practice Address - Country:US
Practice Address - Phone:859-582-6674
Practice Address - Fax:850-939-5221
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 28934225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC7453OtherBCBS
FL$$$$$$$$$OtherUNITED HEALTHCARE