Organization
SUNCOAST AUDIOLOGY, LLC
Active
Other names
SUNCOAST AUDIOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY J DYSON AU.D. (OWNER)
(727) 977-5222
Entity
Organization
Contact information
Practice address
11200 SEMINOLE BLVD STE 301, LARGO, FL 33778-3240
(727) 977-5222
Mailing address
11200 SEMINOLE BLVD STE 301, LARGO, FL 33778-3240
(727) 977-5222
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AY906
FLORIDA STATE LICENSE
FL
Enumeration date
08/27/2019
Last updated
08/27/2019
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