Provider Demographics
NPI:1730594904
Name:SUSAN M. POSADA, PA
Entity type:Organization
Organization Name:SUSAN M. POSADA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MORHARD
Authorized Official - Last Name:POSADA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-215-5558
Mailing Address - Street 1:1001 SYLVIA LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-2004
Mailing Address - Country:US
Mailing Address - Phone:813-215-5558
Mailing Address - Fax:813-354-4769
Practice Address - Street 1:16614 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1400
Practice Address - Country:US
Practice Address - Phone:813-215-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1837106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9904OtherBLUE CROSS BLUE SHIELD