Basic Information
| Provider Information | |||||||||
| NPI: | 1063606630 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOCKSPEISER | ||||||||
| FirstName: | CARYN | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | AUD. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MAYERHOFF | ||||||||
| OtherFirstName: | CARYN | ||||||||
| OtherMiddleName: | SUE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.A. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8940 N KENDALL DR | ||||||||
| Address2: | SUITE 504-E | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055956200 | ||||||||
| FaxNumber: | 3055984071 | ||||||||
| Practice Location | |||||||||
| Address1: | 8940 N KENDALL DR | ||||||||
| Address2: | SUITE 504-E | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055956200 | ||||||||
| FaxNumber: | 3055984071 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2007 | ||||||||
| LastUpdateDate: | 01/07/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AY1205 | FL | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | AY 1205 | 01 | FL | STATE OF FLORIDA AUDIOLOGY LICENSE | OTHER |