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General NPI Number Information
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NPI Number | 1124543756
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Entity Type | Individual
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Provider Name | MARISSA LYNN LEVY AUD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 403 VONDERBURG DR
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City | BRANDON
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State | FL
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Zip | 33511-5501
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Country | US
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Telephone | 813-681-1122
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Fax | 813-684-4924
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Provider Business Mailing Address
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Address Line | 403 VONDERBURG DR
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City | BRANDON
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State | FL
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Zip | 33511-5501
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Country | US
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Telephone | 813-681-1122
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Fax | 813-684-4924
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 4086
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License Number State | SC
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