Provider Demographics
NPI:1548613540
Name:VILLARD, SUZETTE A (RRT)
Entity type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:A
Last Name:VILLARD
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 NW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:FT.LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311
Mailing Address - Country:US
Mailing Address - Phone:954-248-7897
Mailing Address - Fax:
Practice Address - Street 1:532 NW 10TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-8051
Practice Address - Country:US
Practice Address - Phone:954-248-7896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT99822279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care