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General NPI Number Information
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NPI Number | 1598003543
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Entity Type | Individual
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Provider Name | WINNIE J KELLER M.S. CCC/A, FAAA
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Gender | Female
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Dates
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Enumeration Date | 01/26/2013
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Last Update Date | 01/26/2013
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Provider Practice Location Address
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Address Line | 9824 54TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33708-3708
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Country | US
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Telephone | 727-391-0917
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Fax |
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Provider Business Mailing Address
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Address Line | 2524 W KANSAS AVE UNIT A
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City | TAMPA
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State | FL
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Zip | 33629-6330
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Country | US
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Telephone | 813-404-2443
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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 | AY336
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AY336
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License Number State | FL
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