Provider Demographics
NPI:1134781685
Name:SETRIN, KALENE CAMILLE (AUD)
Entity type:Individual
Prefix:DR
First Name:KALENE
Middle Name:CAMILLE
Last Name:SETRIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:KALENE
Other - Middle Name:CAMILLE
Other - Last Name:GUTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1601 CLINT MOORE RD STE 215
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-5716
Mailing Address - Country:US
Mailing Address - Phone:561-939-0177
Mailing Address - Fax:561-338-6271
Practice Address - Street 1:3006 W AZEELE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3139
Practice Address - Country:US
Practice Address - Phone:813-879-8045
Practice Address - Fax:813-450-2461
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2430231H00000X
MSA4600231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9G5YOtherBLUE CROSS BLUE SHIELD
FL115324700Medicaid