MEDICARE: DR. KEVIN THOMAS BARLOW 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	231H00000X	Audiologist	AY235	FL

General Provider Information

NPI Number	:	1770654451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN THOMAS BARLOW AUD

Provider Business Mailing Address
First Line	:	510 1ST ST S
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3601
Country	:	US
Telephone Number	:	863-293-6507
Fax Number	:	863-291-0737

Provider Business Practice Location Address
First Line	:	510 1ST ST S
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3601
Country	:	US
Telephone Number	:	863-293-6507
Fax Number	:	863-291-0737

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	04/23/2012

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