Individual
CALLI KEENAN FODOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
3711 USF CITRUS DRIVE, TAMPA, FL 33620-3120
(813) 974-8804
Mailing address
3711 USF CITRUS DRIVE, TAMPA, FL 33620-0001
(813) 974-8804
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY2309
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123112400
—
FL
01
—
ZXFCN
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/03/2019
Last updated
08/20/2024
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