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Organization

DR. ROSANN W. FAULL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSANN W FAULL AU.D. (AUDIOLOGIST/PRESIDENT)
(904) 262-5550
Entity
Organization

Contact information

Practice address
12276 SAN JOSE BLVD, SUITE 710, JACKSONVILLE, FL 32223-8628
(904) 262-5550
(904) 683-4592
Mailing address
12276 SAN JOSE BLVD, SUITE 710, JACKSONVILLE, FL 32223-8628
(904) 262-5550
(904) 683-4592

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
AY 496
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J000A
BLUECROSS/BLUESHIELD
FL
Enumeration date
01/07/2010
Last updated
01/07/2010
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