Provider Demographics
NPI:1871981878
Name:KILPATRICK, SANDRA
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 SW COLLEGE RD
Mailing Address - Street 2:SUITE 1530
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-4790
Mailing Address - Country:US
Mailing Address - Phone:352-236-6700
Mailing Address - Fax:352-236-6701
Practice Address - Street 1:4414 SW COLLEGE RD
Practice Address - Street 2:SUITE 1530
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4790
Practice Address - Country:US
Practice Address - Phone:352-236-6700
Practice Address - Fax:352-236-6701
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5058237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAS5058OtherSTATE OF FLORIDA BOARD OF HEARING AID SPECIALISTS