Organization
THE BARRANCO CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAILA ARIANA PEREZ AU.D. (AUDIOLOGIST)
(734) 323-9909
Entity
Organization
Contact information
Practice address
160 E LAKE HOWARD DR, WINTER HAVEN, FL 33881-3155
(863) 299-1251
Mailing address
2932 VINTAGE VIEW CIR, LAKELAND, FL 33812-5060
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY2028
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AY2028
AUDIOLOGY LICENSE
FL
Enumeration date
06/15/2016
Last updated
06/17/2016
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