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NPI 1255714721

NPI 1255714721 : ASHLEY WELLONS : JUPITER, FL

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General NPI Number Information
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    NPI Number           |    1255714721
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    Entity Type          |    Individual 
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    Provider Name        |    ASHLEY WELLONS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/02/2015
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    Last Update Date     |    07/15/2015
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Provider Practice Location Address
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    Address Line         |    4600 MILITARY TRL SUITE 205
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    City                 |    JUPITER
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    State                |    FL
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    Zip                  |    33458-4810
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    Country              |    US
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    Telephone            |    561-776-4950
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    900 NW 13TH ST SUITE 206
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    City                 |    BOCA RATON
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    State                |    FL
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    Zip                  |    33486-2335
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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       |    AY1959
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    License Number State |    FL
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