Provider Demographics
NPI:1083843395
Name:CITTA, SUSAN M (LMT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:CITTA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 PRESTWICK CIR
Mailing Address - Street 2:UNIT 2
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8426
Mailing Address - Country:US
Mailing Address - Phone:561-373-0196
Mailing Address - Fax:
Practice Address - Street 1:1216 US HIGHWAY 1
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3537
Practice Address - Country:US
Practice Address - Phone:561-373-0196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA31614225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist