Provider Demographics
NPI:1669148375
Name:KEATING, MEGHAN
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8813 CITRUS VILLAGE DR APT 103
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-3692
Mailing Address - Country:US
Mailing Address - Phone:603-313-8827
Mailing Address - Fax:
Practice Address - Street 1:14540 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6056
Practice Address - Country:US
Practice Address - Phone:352-597-8287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-22
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2517231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist