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General NPI Number Information
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NPI Number | 1013342674
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Entity Type | Organization
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Legal Business Name | CLEAR SOUND AUDIOLOGY
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 2240 NW 40TH TER STE. C
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City | GAINESVILLE
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State | FL
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Zip | 32605-3590
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Country | US
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Telephone | 352-505-6766
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Fax | 352-505-3368
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Provider Business Mailing Address
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Address Line | 2240 NW 40TH TER STE. C
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City | GAINESVILLE
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State | FL
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Zip | 32605-3590
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Country | US
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Telephone | 352-505-6766
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Fax | 352-505-3368
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Authorized Official
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Title or Position | BOARD CERTIFIED AUDIOLOGIST
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Name | DR. JAGADISH MYSORE SWAMY
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Credential | AUD, CCC-A, F-AAA
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Telephone | 352-505-6766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY 1063
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License Number State | FL
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