Provider Demographics
NPI:1770260374
Name:MORGAN, SIMONE ISABELLA (AUD)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:ISABELLA
Last Name:MORGAN
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 1:6421 CONGRESS AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2858
Mailing Address - Country:US
Mailing Address - Phone:813-879-8045
Mailing Address - Fax:
Practice Address - Street 1:5105 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1405
Practice Address - Country:US
Practice Address - Phone:813-879-8045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2745231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist