Provider Demographics
NPI:1043562952
Name:LADIMIR, AMY (HAS, BS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LADIMIR
Suffix:
Gender:F
Credentials:HAS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 SUMMERLIN RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-1073
Mailing Address - Country:US
Mailing Address - Phone:239-334-7800
Mailing Address - Fax:239-275-9080
Practice Address - Street 1:694 8TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5523
Practice Address - Country:US
Practice Address - Phone:239-334-7800
Practice Address - Fax:239-262-3076
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4374237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist