Provider Demographics
NPI:1083617864
Name:THORPE, MARY O (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:O
Last Name:THORPE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 HILLVIEW STREET
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3221
Mailing Address - Country:US
Mailing Address - Phone:941-316-0406
Mailing Address - Fax:941-316-9317
Practice Address - Street 1:2800 HILLVIEW STREET
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3221
Practice Address - Country:US
Practice Address - Phone:941-316-0406
Practice Address - Fax:941-316-9317
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY165237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS0919OtherBCBS
FLS0919ZMedicare ID - Type Unspecified