Provider Demographics
NPI:1720317340
Name:AUDIOLOGY AND HEARING CENTER OF TAMPA LLC
Entity Type:Organization
Organization Name:AUDIOLOGY AND HEARING CENTER OF TAMPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:MANSZE
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:813-920-8777
Mailing Address - Street 1:6906 W LINEBAUGH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5830
Mailing Address - Country:US
Mailing Address - Phone:813-962-1888
Mailing Address - Fax:
Practice Address - Street 1:6906 W LINEBAUGH AVE STE 101
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5830
Practice Address - Country:US
Practice Address - Phone:813-962-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1168231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty