Provider Demographics
NPI:1639194020
Name:PENNINGTON, DARRYL
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:
Last Name:PENNINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8441 SW HIGHWAY 200
Mailing Address - Street 2:SUITE 113
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-9661
Mailing Address - Country:US
Mailing Address - Phone:352-237-4635
Mailing Address - Fax:352-861-4646
Practice Address - Street 1:8441 SW STATE RD 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481
Practice Address - Country:US
Practice Address - Phone:800-237-4635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2879237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist