Provider Demographics
NPI:1780937102
Name:ROUSE, GARY P (HAS, BC-HIS)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:P
Last Name:ROUSE
Suffix:
Gender:M
Credentials:HAS, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 N BENEVA RD STE 713
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-1338
Mailing Address - Country:US
Mailing Address - Phone:941-953-4474
Mailing Address - Fax:941-953-6414
Practice Address - Street 1:935 N BENEVA RD STE 713
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-1338
Practice Address - Country:US
Practice Address - Phone:941-953-4474
Practice Address - Fax:941-953-6414
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS-2563237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist