MEDICARE: DR. LOUIS WOLFE VALENTINE AU.D., 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	237600000X	Audiologist-Hearing Aid Fitter	AY1907	FL

General Provider Information

NPI Number	:	1477875599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS WOLFE VALENTINE AU.D., CCC-A

Provider Business Mailing Address
First Line	:	750 N COMMONS DR STE 200
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7940
Country	:	US
Telephone Number	:	630-303-5380
Fax Number	:	630-303-5385

Provider Business Practice Location Address
First Line	:	861 W BAY DR
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33770-3221
Country	:	US
Telephone Number	:	727-518-1111
Fax Number	:	727-518-1110

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

Provider Enumeration Date	:	02/16/2010
Last Update Date	:	07/16/2020

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