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General NPI Number Information
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NPI Number | 1790988731
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Entity Type | Individual
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Provider Name | JULIE NICOLE WILEY AU.D.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3007 RIDGELINE BLVD STE A
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-9103
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Country | US
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Telephone | 727-942-4005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 152198
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City | TAMPA
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State | FL
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Zip | 33684-2198
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Country | US
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Telephone | 813-293-2384
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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 | AY923
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License Number State | FL
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