Provider Demographics
NPI:1982828083
Name:BUSSELL, MARGARET JANE (DOCTOR OF AUDIOLOGY)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JANE
Last Name:BUSSELL
Suffix:
Gender:F
Credentials:DOCTOR OF AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SHERIDAN ST
Mailing Address - Street 2:SUITE K
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3420
Mailing Address - Country:US
Mailing Address - Phone:954-966-7000
Mailing Address - Fax:
Practice Address - Street 1:4700 SHERIDAN ST
Practice Address - Street 2:SUITE K
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3420
Practice Address - Country:US
Practice Address - Phone:954-966-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY-580231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6002480Medicaid
FLAO883ZMedicare PIN