Provider Demographics
NPI:1598237976
Name:ALMARZA SOSA, SUSANA J (BA)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:J
Last Name:ALMARZA SOSA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 PLANTATION GROVE CT APT 1120
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-1592
Mailing Address - Country:US
Mailing Address - Phone:813-359-7061
Mailing Address - Fax:
Practice Address - Street 1:1504 PLANTATION GROVE CT APT 1120
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566-1592
Practice Address - Country:US
Practice Address - Phone:813-359-7061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-22
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency