Provider Demographics
NPI:1437339538
Name:SCHNACK, SUSAN MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:SCHNACK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:GUTHRIE
Other - Last Name:SCHNACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:5455 FRUITVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6418
Mailing Address - Country:US
Mailing Address - Phone:941-341-9444
Mailing Address - Fax:941-341-9447
Practice Address - Street 1:5455 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6418
Practice Address - Country:US
Practice Address - Phone:941-341-9444
Practice Address - Fax:941-341-9447
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY631231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS1411YMedicare UPIN