Individual
DR. ROSANN W. FAULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DOCTOR OF AUDIOLOGY
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
231H00000X
Audiologist
Primary
AY 496
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005314
—
FL
01
—
J000A
BLUECROSS/BLUESHIELD
FL
Enumeration date
03/13/2007
Last updated
12/09/2009
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