| Organization Name: | ISLAND AUDIOLOGY, LLC |
| NPI Number: | 1811265051 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEIDI D ROBERTS-FORDHAM (OWNER/AUDIOLOGIST) |
| Mailing Address: | 13999 Gulf Blvd Ste C4 Madeira Beach |
| State: | FL US |
| Postal Code: | 337082677 |
| Phone Number: | 7273298683 |
| Fax Number: | |
| NPI Enumeration Date: | 12/02/2011 |
| NPI Last Update Date: | 12/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0700X |
| License Number: | AY1366 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Hearing and Speech |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |