NPI 1063854529

Benjamin Russell, AUD

Practitioner Audiologist Tampa, FL

Practice location

Address: 4202 E Fowler Ave Pcd1017, Tampa, FL 33620-8200
Phone: (813) 974-8804

Registered specialties

Audiologist Primary

Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence AY1685 (FL)

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Registry record

NPI: 1063854529
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jul 2013
Record last updated: 25 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.