Provider Demographics
NPI:1598003287
Name:YAMPOLSKY, SANDRA (BA/BS)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:YAMPOLSKY
Suffix:
Gender:F
Credentials:BA/BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12281 LEXINGTON PARK DR APT 101
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2729
Mailing Address - Country:US
Mailing Address - Phone:954-305-0722
Mailing Address - Fax:
Practice Address - Street 1:880 6TH ST S DEPT 7700
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4827
Practice Address - Country:US
Practice Address - Phone:954-305-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAZ651231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist