Provider Demographics
NPI:1932486065
Name:SUTHERLAND, ALAN CLAYTON (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:CLAYTON
Last Name:SUTHERLAND
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20239 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1769
Mailing Address - Country:US
Mailing Address - Phone:727-461-8870
Mailing Address - Fax:727-461-8739
Practice Address - Street 1:430 MORTON PLANT ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3398
Practice Address - Country:US
Practice Address - Phone:727-461-8870
Practice Address - Fax:727-461-8739
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY191231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist