Provider Demographics
NPI:1821198219
Name:LIVOTI, SUZANNE M (SLP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:LIVOTI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 BLACKWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1210
Mailing Address - Country:US
Mailing Address - Phone:727-535-6746
Mailing Address - Fax:727-536-6006
Practice Address - Street 1:14141 46TH ST N
Practice Address - Street 2:#1202
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3868
Practice Address - Country:US
Practice Address - Phone:727-535-6746
Practice Address - Fax:727-536-6006
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist