Provider Demographics
NPI:1669501995
Name:MILANA, SUZETTE MILANA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:MILANA
Last Name:MILANA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:SUZETTE
Other - Middle Name:MILANA
Other - Last Name:FEINSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3314 HENDERSON BLVD
Mailing Address - Street 2:#107
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2999
Mailing Address - Country:US
Mailing Address - Phone:813-985-1852
Mailing Address - Fax:813-987-2563
Practice Address - Street 1:3314 HENDERSON BLVD
Practice Address - Street 2:SUITE # 107
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2999
Practice Address - Country:US
Practice Address - Phone:813-985-1852
Practice Address - Fax:813-987-2563
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 3241103T00000X
FLPY3241103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73401Medicare UPIN