Provider Demographics
NPI:1053864397
Name:MCCLAIN, ELHAUM (AUD)
Entity Type:Individual
Prefix:MRS
First Name:ELHAUM
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:ELHAUM
Other - Middle Name:
Other - Last Name:MOGHARREBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:10002 PRINCESS PALM AVE STE 332
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-8327
Mailing Address - Country:US
Mailing Address - Phone:813-571-7184
Mailing Address - Fax:813-654-4695
Practice Address - Street 1:5 TAMPA GENERAL CIR STE 610
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3659
Practice Address - Country:US
Practice Address - Phone:813-315-4327
Practice Address - Fax:813-315-4329
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2063231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIW022ZMedicare UPIN