Audrey Susan Tyler

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA1267 Issued in FL

Practice address

1219 Dunn Ave
Daytona Beach, FL 32114-2405

Phone

(386) 255-4568

Fax

(386) 258-7677

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Audrey Susan Tyler Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225050289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LAKEBRIDGE PLAZA DR",
            "address_2": "APARTMENT 1005",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142405",
            "telephone_number": "386-255-4568",
            "fax_number": "386-258-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "AUDREY",
        "middle_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA1267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "TYLER",
            "middle_name": "SUSAN",
            "credential": "MS,CCC/SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Speech-Language Pathologist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.