Healthcare Provider Details

I. General information

NPI: 1205006947
Provider Name (Legal Business Name): TAMMY LYNN RIEGNER-VITALE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY LR DEOLIVEIRA M.S. CCC/A

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 LAKELAND HIGHLANDS RD
LAKELAND FL
33803-4338
US

IV. Provider business mailing address

3020 LAKELAND HIGHLANDS RD
LAKELAND FL
33803-4338
US

V. Phone/Fax

Practice location:
  • Phone: 863-686-3189
  • Fax: 863-682-1348
Mailing address:
  • Phone: 863-686-3189
  • Fax: 863-682-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2991
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: