Provider Demographics
NPI:1013342674
Name:CLEAR SOUND AUDIOLOGY
Entity Type:Organization
Organization Name:CLEAR SOUND AUDIOLOGY
Other - Org Name:CLEAR SOUND AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD CERTIFIED AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGADISH
Authorized Official - Middle Name:MYSORE
Authorized Official - Last Name:SWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A, F-AAA
Authorized Official - Phone:352-505-6766
Mailing Address - Street 1:2240 NW 40TH TER
Mailing Address - Street 2:STE. C
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3590
Mailing Address - Country:US
Mailing Address - Phone:352-505-6766
Mailing Address - Fax:352-505-3368
Practice Address - Street 1:2240 NW 40TH TER
Practice Address - Street 2:STE. C
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3590
Practice Address - Country:US
Practice Address - Phone:352-505-6766
Practice Address - Fax:352-505-3368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1063231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty