Provider Demographics
NPI:1427182070
Name:HESSE, SUSANNE SETUH (LMT)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:SETUH
Last Name:HESSE
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 1:29003 NW 182ND TER
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-3103
Mailing Address - Country:US
Mailing Address - Phone:386-462-5125
Mailing Address - Fax:
Practice Address - Street 1:1135 NW 23RD AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-5415
Practice Address - Country:US
Practice Address - Phone:352-376-8410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0006467225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC6091OtherBLUECROSS BLUE SHIELD