MEDICARE: MRS. CHARLENE VILA COTTRELL M.S.,CCC-A

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	231H00000X	Audiologist	AY687	FL

General Provider Information

NPI Number	:	1447227079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHARLENE VILA COTTRELL M.S.,CCC-A

Provider Business Mailing Address
First Line	:	9912 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-3419
Country	:	US
Telephone Number	:	727-869-4200
Fax Number	:	727-869-4148

Provider Business Practice Location Address
First Line	:	9912 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-3419
Country	:	US
Telephone Number	:	727-869-4200
Fax Number	:	727-869-4148

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. CHARLENE VILA COTTRELL M.S.,CCC-A” Practice Location

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