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General NPI Number Information
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NPI Number | 1184392706
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Entity Type | Individual
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Provider Name | ALINA ROANNE LASRADO AUD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 963 TOWN CENTER DRIVE SUITE 100
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City | ORANGE CITY
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State | FL
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Zip | 32763-8254
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Country | US
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Telephone | 386-774-9880
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Fax | 386-774-2898
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Provider Business Mailing Address
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Address Line | 15280 NW 79TH CT STE 200
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5873
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Country | US
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Telephone | 305-558-3724
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Fax | 786-907-4485
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY2559
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-3097
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License Number State | NV
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