Provider Demographics
NPI:1255483467
Name:FELLER, GARY LEE (HEARING AID SPECIALI)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:LEE
Last Name:FELLER
Suffix:
Gender:M
Credentials:HEARING AID SPECIALI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5857 96TH CIR
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-3234
Mailing Address - Country:US
Mailing Address - Phone:727-898-7500
Mailing Address - Fax:727-548-9093
Practice Address - Street 1:5857 96TH CIR
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-3234
Practice Address - Country:US
Practice Address - Phone:727-898-7500
Practice Address - Fax:727-548-9093
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS1987237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist