Provider Demographics
NPI:1063606630
Name:LOCKSPEISER, CARYN SUE (AUD)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:SUE
Last Name:LOCKSPEISER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:SUE
Other - Last Name:MAYERHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:8940 N KENDALL DR
Practice Address - Street 2:SUITE 504-E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2148
Practice Address - Country:US
Practice Address - Phone:305-595-6200
Practice Address - Fax:305-598-4071
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1205231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY 1205OtherSTATE OF FLORIDA AUDIOLOGY LICENSE
AJ492ZMedicare PIN