Provider Demographics
NPI:1285863159
Name:COUDURIER, JULIE ANN (AUD)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:COUDURIER
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 1:6906 W LINEBAUGH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5830
Mailing Address - Country:US
Mailing Address - Phone:813-962-1888
Mailing Address - Fax:813-369-5337
Practice Address - Street 1:7001 N DALE MABRY HWY
Practice Address - Street 2:#2
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3910
Practice Address - Country:US
Practice Address - Phone:813-558-4920
Practice Address - Fax:813-558-4921
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1295231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002240200Medicaid