Barbra Gussow Antonelli

Key facts

NPI

1689809709

Entity type

Individual (NPI type 1)

Primary specialty

Audiologist 231H00000X

License

AZ 559 (FL)

Practice address

4443 Rowan Rd
New Port Richey, FL 34653-6198

Phone

(727) 846-9900

NPI assigned

May 19, 2009

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 19, 2009.

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1689809709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 WILD OAK LN",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346833033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4443 ROWAN RD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346536198",
            "telephone_number": "727-846-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONELLI",
        "first_name": "BARBRA",
        "middle_name": "GUSSOW",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AZ 559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in New Port Richey, FL · Audiologist in Florida