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Individual

KENTON STEPHEN TARVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUD

Contact information

Practice address
8200 BRYAN DAIRY RD, SUITE 340, LARGO, FL 33777
(727) 398-5728
(727) 398-4914
Mailing address
8200 BRYAN DAIRY RD, SUITE 340, LARGO, FL 33777
(727) 398-5728
(727) 398-4914

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1318
FL
237600000X
Audiologist-Hearing Aid Fitter
AY1318
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33023
MEDICARE GROUP #
FL
01
S9133
BCBS
FL
Enumeration date
12/09/2005
Last updated
03/29/2010
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