Provider Demographics
NPI:1902327786
Name:SHASHATY, ARIELLE ELIZABETH (AUD)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:ELIZABETH
Last Name:SHASHATY
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 1:5119 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1996
Mailing Address - Country:US
Mailing Address - Phone:352-666-8911
Mailing Address - Fax:352-683-6889
Practice Address - Street 1:13101 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5052
Practice Address - Country:US
Practice Address - Phone:352-666-8911
Practice Address - Fax:352-683-6889
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2125231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY2125OtherFLORIDA MEDICAL LICENSE