Individual provider Active NPI

Jaclyn Marie Kowalonek, AUD

  • Audiologist
  • Weston, FL
National Provider Identifier
1154848059
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2124 Issued in FL
Practice address
2500 Weston Rd Ste 103
Weston, FL 33331-3616
Phone
(954) 389-1414
Fax
(954) 389-4201
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY2124 FL Primary

Addresses

Primary practice location

2500 Weston Rd Ste 103
Weston, FL 33331-3616

Mailing address

2500 Weston Rd Ste 103
Weston, FL 33331-3616
Phone (954) 389-1414

Other practice location 1

601 N Flamingo Rd Ste 210
Pembroke Pines, FL 33028-1009
Phone (954) 438-1015 ext. 110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY2124FLMDAudiologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154848059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 WESTON RD STE 103",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313616",
            "telephone_number": "954-389-1414",
            "fax_number": "954-389-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WESTON RD STE 103",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313616",
            "telephone_number": "954-389-1414",
            "fax_number": "954-389-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Flamingo Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281009",
            "country_code": "US",
            "telephone_number": "954-438-1015 x110",
            "fax_number": "954-450-0636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALONEK",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.