Provider Demographics
NPI:1104487099
Name:MOREHOUSE, WILLIAM ALLEN (HAS, AS5151)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALLEN
Last Name:MOREHOUSE
Suffix:
Gender:M
Credentials:HAS, AS5151
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6144 ABBOTT STATION DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-4826
Mailing Address - Country:US
Mailing Address - Phone:813-395-6764
Mailing Address - Fax:
Practice Address - Street 1:6144 ABBOTT STATION DR STE 102
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-4826
Practice Address - Country:US
Practice Address - Phone:813-395-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-22
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5151237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty