Individual
MS. CECILIA M WICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
729 CORTARO DR, RUSKIN, FL 33573-6812
(813) 633-0842
Mailing address
PO BOX 406153, ATLANTA, GA 30384-1876
(561) 478-8770
(561) 688-8877
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY871
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4899832
GHI
FL
05
—
600321400
—
FL
Enumeration date
07/04/2006
Last updated
10/09/2008
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