Healthcare Provider Details

I. General information

NPI: 1326186560
Provider Name (Legal Business Name): JOSEPH D SPARKS AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 NW 10TH AVE
GAINESVILLE FL
32601-4154
US

IV. Provider business mailing address

1225 NW 10TH AVE
GAINESVILLE FL
32601-4154
US

V. Phone/Fax

Practice location:
  • Phone: 352-375-1559
  • Fax:
Mailing address:
  • Phone: 352-375-1559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY52
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License NumberAY52
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY52
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: