| Susan V Sims, Llc | |
|
3601 W Azeele St Tampa FL 33609-2805 | |
| (813) 874-0608 | |
| (813) 350-9544 |
| Full Name | Susan V Sims, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3601 W Azeele St, Tampa, Florida |
| Authorized Official Name and Position | Susan V Sims (OWNER) |
| Authorized Official Contact | 8138740608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan V Sims, Llc 3601 W Azeele St Tampa FL 33609-2805 Ph: (813) 874-0608 | Susan V Sims, Llc 3601 W Azeele St Tampa FL 33609-2805 Ph: (813) 874-0608 |
| NPI Number | 1578824413 |
|---|---|
| Provider Enumeration Date | 06/07/2012 |
| Last Update Date | 06/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578824413 | NPI | - | NPPES |
| 000048900 | Medicaid | FL | |
| 1407907017 | Other | FL | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH4365 (Florida) | Primary |
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