Provider Demographics
NPI:1497151211
Name:PERRY, ELIZABETH (BA,HAS,BC-HIS)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:BA,HAS,BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 TAMIAMI TRL
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-2180
Mailing Address - Country:US
Mailing Address - Phone:941-743-5211
Mailing Address - Fax:941-743-6380
Practice Address - Street 1:1900 TAMIAMI TRL
Practice Address - Street 2:SUITE 109
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-2180
Practice Address - Country:US
Practice Address - Phone:941-743-5211
Practice Address - Fax:941-743-6380
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS 3470237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist