Provider Demographics
NPI:1134391980
Name:HUDAK, DEBBIE (MS -CCC-A)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:HUDAK
Suffix:
Gender:F
Credentials:MS -CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 FLOYD ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2932
Mailing Address - Country:US
Mailing Address - Phone:941-366-9222
Mailing Address - Fax:941-365-2269
Practice Address - Street 1:1901 FLOYD ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2932
Practice Address - Country:US
Practice Address - Phone:941-366-9222
Practice Address - Fax:941-365-2269
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY96231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS1196ZMedicare PIN