Provider Demographics
NPI:1790329316
Name:MURRAY, SUZANNE L (OT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:L
Last Name:MURRAY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7717 GENEVA LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-4217
Mailing Address - Country:US
Mailing Address - Phone:225-241-0309
Mailing Address - Fax:
Practice Address - Street 1:7500 4TH ST N STE B
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5400
Practice Address - Country:US
Practice Address - Phone:727-288-6279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9851225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty