Provider Demographics
NPI:1104577113
Name:DURRANCE, TOMI LYNN (HAS)
Entity type:Individual
Prefix:MS
First Name:TOMI
Middle Name:LYNN
Last Name:DURRANCE
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 HIDDEN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-8842
Mailing Address - Country:US
Mailing Address - Phone:352-424-0401
Mailing Address - Fax:
Practice Address - Street 1:3020 LAKELAND HIGHLANDS RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4338
Practice Address - Country:US
Practice Address - Phone:863-686-3189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4391237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist