Healthcare Provider Details

I. General information

NPI: 1720139025
Provider Name (Legal Business Name): CAROL ANN CLINGERMAN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROL ANN HENN-STAINO AU.D.

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11304 STATE ROAD 54
TRINITY FL
34655-2294
US

IV. Provider business mailing address

11304 STATE ROAD 54
TRINITY FL
34655-2294
US

V. Phone/Fax

Practice location:
  • Phone: 727-247-1234
  • Fax: 727-247-1236
Mailing address:
  • Phone: 727-247-1234
  • Fax: 727-247-1236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2144
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: