Provider Demographics
NPI:1578672804
Name:WALDEN, ERNEST EARL JR (MA)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:EARL
Last Name:WALDEN
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1111 NE 25TH AVE
Mailing Address - Street 2:#204
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-5675
Mailing Address - Country:US
Mailing Address - Phone:352-671-3277
Mailing Address - Fax:352-671-8164
Practice Address - Street 1:1111 NE 25TH AVE
Practice Address - Street 2:#204
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-5675
Practice Address - Country:US
Practice Address - Phone:352-671-3277
Practice Address - Fax:352-671-8164
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY123231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist