Healthcare Provider Details

I. General information

NPI: 1417008434
Provider Name (Legal Business Name): AUDIOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 W LUMSDEN RD
BRANDON FL
33511-5911
US

IV. Provider business mailing address

675 W LUMSDEN RD
BRANDON FL
33511-5911
US

V. Phone/Fax

Practice location:
  • Phone: 813-643-1652
  • Fax: 813-643-1786
Mailing address:
  • Phone: 813-643-1652
  • Fax: 813-643-1786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY979
License Number StateFL

VIII. Authorized Official

Name: DR. MARIA ELENA ROMERO
Title or Position: PRESIDENT AUDIOLOGIST
Credential: AU.D.
Phone: 813-643-1652