Provider Demographics
NPI:1780831495
Name:EIFFERT, CASSIE LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:LYNN
Last Name:EIFFERT
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 1:11650 CAPRI CIR S
Mailing Address - Street 2:#203
Mailing Address - City:TREASURE ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33706-4996
Mailing Address - Country:US
Mailing Address - Phone:352-256-6816
Mailing Address - Fax:
Practice Address - Street 1:10,000 BAY PINES BLVD.
Practice Address - Street 2:
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-5005
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-319-1209
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1500231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist