Provider Demographics
NPI:1477748721
Name:KAESER, SUSAN L (ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:KAESER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11881-A E. COLONIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4723
Mailing Address - Country:US
Mailing Address - Phone:407-322-8645
Mailing Address - Fax:407-273-2181
Practice Address - Street 1:11881-A E. COLONIAL DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4723
Practice Address - Country:US
Practice Address - Phone:407-367-0064
Practice Address - Fax:407-322-8725
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP0941702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01204425OtherAMERIGROUP
FL308902900Medicaid
FL439532OtherWELLCARE
FL439532OtherWELLCARE