Individual
PATRICIA IRENE CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCCA
Contact information
Practice address
4202 E FOWLER AVE, PCD1017, TAMPA, FL 33620
(813) 974-8804
(813) 974-0822
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY487
FL
237600000X
Audiologist-Hearing Aid Fitter
AY487
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600460100
—
FL
05
—
600460101
—
FL
01
—
S9093
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/02/2006
Last updated
06/08/2018
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