Organization
STACY O'BRIEN AUDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY A O'BRIEN AU.D. (OWNER/OPERATOR)
(813) 767-0938
Entity
Organization
Contact information
Practice address
1185 DUNLAWTON AVE, SUITE 103, PORT ORANGE, FL 32127-2905
(813) 767-0938
Mailing address
4624 RIVERWALK VILLAGE CT, PONCE INLET, FL 32127-7261
(813) 767-0938
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
L14000162663
FL
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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