Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mallory Sussman

Individual provider Family Nurse Practitioner · NPI 1194375899

Mallory Sussman is a Nurse Practitioner in Tampa, Florida. Qualified in 2019, 7 years ago. Practices with Sage Infusion, LLC, a 45-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
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Practice location Address checks out

13511 Ironton Dr
Tampa, FL 33626-2967
Phone: (813) 340-5322
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN11004009 (FL)

Record details

NPI number1194375899
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 13, 2019
Last updated in NPPESMarch 25, 2024
Certification dateMarch 25, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Sage Infusion, Llc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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