Provider Demographics
NPI:1366673972
Name:HUMPHREY, SUZIE (RRT)
Entity Type:Individual
Prefix:MRS
First Name:SUZIE
Middle Name:
Last Name:HUMPHREY
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 1:3821 MCFARLANE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2187
Mailing Address - Country:US
Mailing Address - Phone:850-933-1641
Mailing Address - Fax:
Practice Address - Street 1:1236 BLOUNTSTOWN HWY
Practice Address - Street 2:PARK 20 WEST, BLDG 5
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-2715
Practice Address - Country:US
Practice Address - Phone:850-701-3920
Practice Address - Fax:850-701-3924
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT6214227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered