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NPI Code Detail

MEDICARE: HOLLY WILLIAMS GRADY AU.D.

MEDICARE: HOLLY WILLIAMS GRADY AU.D.
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
1231H00000XAudiologistAY996FL

General Provider Information

NPI Number : 1508974247
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY WILLIAMS GRADY AU.D.
Provider Business Mailing Address
First Line : 5830 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-4311
Country : US
Telephone Number : 407-658-0228
Fax Number : 407-282-5483
Provider Business Practice Location Address
First Line : 5830 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-4311
Country : US
Telephone Number : 407-658-0228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 09/24/2008

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Directions to “ HOLLY WILLIAMS GRADY AU.D.” Practice Location

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