MEDICARE: MELISSA PE SIROIS AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AY1139	FL
2	237600000X	Audiologist-Hearing Aid Fitter	AY1139	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477556413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA PE SIROIS AUD

Provider Business Mailing Address
First Line	:	27516 CASHFORD CIR # 101
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-6910
Country	:	US
Telephone Number	:	813-406-4400
Fax Number	:	813-929-6633

Provider Business Practice Location Address
First Line	:	6310 FORT KING RD
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-2531
Country	:	US
Telephone Number	:	813-406-4400
Fax Number	:	813-929-6633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	06/24/2024

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