Provider Demographics
NPI:1376862870
Name:FARRIS, SUSAN CRANE (RRT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:CRANE
Last Name:FARRIS
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 1:8624 SW 45TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4134
Mailing Address - Country:US
Mailing Address - Phone:352-335-6333
Mailing Address - Fax:
Practice Address - Street 1:2025 SW 75TH ST
Practice Address - Street 2:SUITE 30
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-3453
Practice Address - Country:US
Practice Address - Phone:352-333-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT1301227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered