Individual
MARY J BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU D
Contact information
Practice address
502 PASADENA AVE S, SAINT PETERSBURG, FL 33707-2126
(727) 289-1212
(727) 289-9901
Mailing address
502 PASADENA AVE S, SAINT PETERSBURG, FL 33707-2126
(727) 289-1212
(727) 289-9901
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
0451
KY
231H00000X
Audiologist
Primary
AY1803
FL
237700000X
Hearing Instrument Specialist
0923
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381573
ANTHEM
KY
01
—
200533170
MEDICAID
IN
01
—
P00436413
MEDICARE RAILROAD
KY
Enumeration date
02/09/2006
Last updated
07/21/2022
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