MEDICARE: DR. MARILYN KAY LARKIN AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	AY224	FL
2	231H00000X	Audiologist
3	231HA2400X	Assistive Technology Practitioner Audiologist
4	231HA2500X	Assistive Technology Supplier Audiologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S1470	OTHER		BLUE CROSS BLUE SHIELD
2	T0912	OTHER		BCBS

General Provider Information

NPI Number	:	1225020969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARILYN KAY LARKIN AUD

Provider Business Mailing Address
First Line	:	3829 BERMUDA CT
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-8123
Country	:	US
Telephone Number	:	941-637-3950
Fax Number	:	941-505-0022

Provider Business Practice Location Address
First Line	:	100 MADRID BLVD
Second Line	:	STE 315
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-7968
Country	:	US
Telephone Number	:	941-505-0400
Fax Number	:	941-505-0022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	06/18/2013

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Directions to “ DR. MARILYN KAY LARKIN AUD” Practice Location

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