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General NPI Number Information
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NPI Number | 1750595039
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Entity Type | Organization
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Legal Business Name | GULF COAST AUDIOLOGY INC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1622 N MISSOURI AVE
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City | LARGO
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State | FL
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Zip | 33770
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Country | US
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Telephone | 727-518-2400
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Fax | 727-559-8864
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Provider Business Mailing Address
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Address Line | 1622 N MISSOURI AVE
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City | LARGO
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State | FL
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Zip | 33770
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Country | US
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Telephone | 727-518-2400
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Fax | 727-559-8864
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Authorized Official
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Title or Position | PRES
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Name | MRS. LINDA M WALSTON
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Credential | MA CCCA
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Telephone | 727-518-2400
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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 | AY808
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License Number State | FL
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