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General NPI Number Information
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NPI Number | 1891704961
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Entity Type | Organization
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Legal Business Name | ANCLOTE HEARING CENTERS, INC
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Dates
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Enumeration Date | 08/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5139 US HIGHWAY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-3966
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Country | US
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Telephone | 727-849-6076
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Fax | 727-848-2830
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Provider Business Mailing Address
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Address Line | 5139 US HIGHWAY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-3966
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Country | US
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Telephone | 727-849-6076
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Fax | 727-848-2830
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LYDIA GLADWIN
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Credential | AU.D.
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Telephone | 727-849-6076
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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 | AY1140
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License Number State | FL
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