Provider Demographics
NPI:1982037305
Name:GAINES, EMILY ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ANN
Last Name:GAINES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:SILCOX (MAIDEN)
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0174
Mailing Address - Country:US
Mailing Address - Phone:352-351-3977
Mailing Address - Fax:
Practice Address - Street 1:40 SW 12TH ST STE C201
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6521
Practice Address - Country:US
Practice Address - Phone:352-351-3977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1691237600000X
FLAY1806231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103594700Medicaid
TNQ012693Medicaid