Healthcare Provider Details

I. General information

NPI: 1780720920
Provider Name (Legal Business Name): PAULA ROSE GOLSON MS, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 6TH ST S #7700
ST PETERSBURG FL
33701-4816
US

IV. Provider business mailing address

801 6TH ST S #7700
ST PETERSBURG FL
33701-4816
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-6912
  • Fax: 727-767-6757
Mailing address:
  • Phone: 727-767-6912
  • Fax: 727-767-6757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY319
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: