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Organization
GULF COAST AUDIOLOGY OF SOUTHWEST FLORIDA LLC
Active
Organization
GULF COAST AUDIOLOGY OF SOUTHWEST FLORIDA LLC
Active
Other names
Gulf Coast Audiology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DRIANIS DURAN AU.D. (AUDIOLOGIST/OWNER)
(239) 267-7888
Entity
Organization
Contact information
Practice address
8900 GLADIOLUS DR, SUITE 201, FORT MYERS, FL 33908-4487
(239) 267-7888
(239) 267-0409
Mailing address
8900 GLADIOLUS DR, SUITE 201, FORT MYERS, FL 33908-4487
(239) 267-7888
(239) 267-0409
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
AY1164
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01088308
AMERIGROUP
—
01
—
0140162
GHI
—
01
—
1548335813
TRICARE
—
05
—
600507100
—
FL
01
—
S9326
BCBS
—
Enumeration date
05/02/2008
Last updated
07/11/2008
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