Provider Demographics
NPI:1659777977
Name:CARL, ANJA (AUD)
Entity type:Individual
Prefix:
First Name:ANJA
Middle Name:
Last Name:CARL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ANJA
Other - Middle Name:
Other - Last Name:ARKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1600 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3065
Mailing Address - Country:US
Mailing Address - Phone:863-680-7000
Mailing Address - Fax:866-264-8519
Practice Address - Street 1:1755 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3109
Practice Address - Country:US
Practice Address - Phone:863-904-6296
Practice Address - Fax:866-264-8519
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2767231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2926OtherSTATE LICENSE