Vasiloff, Mary Forsyth

Vasiloff, Mary Forsyth is an individual health care provider with primary practice located at 26C Racetrack Rd Nw , Fort Walton Beach FL 32547-1622. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Vasiloff, Mary Forsyth can be contacted via phone (850) 226-6633.

Contact Information

Primary practice address
26C Racetrack Rd Nw Fort Walton Beach FL 32547-1622
Phone: (850) 226-6633
Fax: (850) 226-6883
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AY649 Florida

Profile Details

NPI number 1578589230
LBN Legal business name Vasiloff, Mary Forsyth
Credentials AU.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Aug 21st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578589230 NPPES
Florida Other S1811 BLUE CROSS BLUE SHIELD
Florida MEDICAID 300361300 BLUE CROSS BLUE SHIELD

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