Provider Demographics
NPI:1447418249
Name:D'ORAZIO, SUSAN C (DOM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:D'ORAZIO
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9070 58TH DR E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6110
Mailing Address - Country:US
Mailing Address - Phone:941-586-8061
Mailing Address - Fax:941-306-5170
Practice Address - Street 1:9070 58TH DR E
Practice Address - Street 2:SUITE 102
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-6110
Practice Address - Country:US
Practice Address - Phone:941-586-8061
Practice Address - Fax:941-306-5170
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2137171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist