Provider Demographics
NPI:1487183687
Name:POWERS, ELIZABETH SIMMONS (AUD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SIMMONS
Last Name:POWERS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 NIKKI VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4879
Mailing Address - Country:US
Mailing Address - Phone:813-571-7184
Mailing Address - Fax:813-654-4695
Practice Address - Street 1:5 TAMPA GENERAL CIR STE 610
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3659
Practice Address - Country:US
Practice Address - Phone:813-315-4327
Practice Address - Fax:813-315-4329
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2123231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist