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General NPI Number Information
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NPI Number | 1982711834
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Entity Type | Individual
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Provider Name | ELISE ANNE DIMON M.S.
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Gender | Female
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4896 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34231-4352
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Country | US
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Telephone | 941-921-3546
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Fax | 941-926-2839
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Provider Business Mailing Address
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Address Line | 56 MEDALIST CT
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City | ROTONDA WEST
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State | FL
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Zip | 33947-2170
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Country | US
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Telephone | 941-697-2273
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Fax | 941-697-2273
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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 | AY1269
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License Number State | FL
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