Healthcare Provider Details

I. General information

NPI: 1891704961
Provider Name (Legal Business Name): ANCLOTE HEARING CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5139 US HIGHWAY 19
NEW PORT RICHEY FL
34652-3966
US

IV. Provider business mailing address

5139 US HIGHWAY 19
NEW PORT RICHEY FL
34652-3966
US

V. Phone/Fax

Practice location:
  • Phone: 727-849-6076
  • Fax: 727-848-2830
Mailing address:
  • Phone: 727-849-6076
  • Fax: 727-848-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1140
License Number StateFL

VIII. Authorized Official

Name: DR. LYDIA GLADWIN
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 727-849-6076