Basic Information
| Provider Information | |||||||||
| NPI: | 1881638476 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCKINNEY | ||||||||
| FirstName: | ROSEMARY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 752 N BELCHER RD | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337652138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274468392 | ||||||||
| FaxNumber: | 7274427637 | ||||||||
| Practice Location | |||||||||
| Address1: | 752 N BELCHER RD | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337652138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274468392 | ||||||||
| FaxNumber: | 7274427637 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 11/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | AS2469 | FL | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
ID Information
| ID | Type | State | Issuer | Description | T0927 | 01 | FL | BCBS GROUP ID # | OTHER |