Healthcare Provider Details

I. General information

NPI: 1457356644
Provider Name (Legal Business Name): DENISE LYNN PARRISH AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date: 03/17/2006
Reactivation Date: 03/31/2006

III. Provider practice location address

300 RIVERSIDE DR E STE 1600
BRADENTON FL
34208-1022
US

IV. Provider business mailing address

300 RIVERSIDE DR E STE 1600
BRADENTON FL
34208-1022
US

V. Phone/Fax

Practice location:
  • Phone: 941-745-1518
  • Fax: 941-745-1343
Mailing address:
  • Phone: 941-745-1518
  • Fax: 941-745-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY033
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: