Provider Demographics
NPI:1306100300
Name:PULIDO, JENILEE PERLAS (AUD)
Entity type:Individual
Prefix:
First Name:JENILEE
Middle Name:PERLAS
Last Name:PULIDO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JENILEE
Other - Middle Name:MAE
Other - Last Name:PERLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1878 EAGLE TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3311
Mailing Address - Country:US
Mailing Address - Phone:727-641-0873
Mailing Address - Fax:
Practice Address - Street 1:2800 HILLVIEW ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3221
Practice Address - Country:US
Practice Address - Phone:941-316-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1733231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist