Healthcare Provider Details

I. General information

NPI: 1336067388
Provider Name (Legal Business Name): AZALEA COSTE AUD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MUSGROVE RD STE 203
SILVER SPRING MD
20904-5228
US

IV. Provider business mailing address

4009 GALLATIN ST APT 205
HYATTSVILLE MD
20781-2148
US

V. Phone/Fax

Practice location:
  • Phone: 301-989-2300
  • Fax: 301-236-5357
Mailing address:
  • Phone: 240-413-0890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: