Provider Demographics
NPI:1679574065
Name:MONTAUDO, RENEE LOKENBERG (AUD)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:LOKENBERG
Last Name:MONTAUDO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:SUSAN
Other - Last Name:LOKENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:8200 BRYAN DAIRY RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1363
Mailing Address - Country:US
Mailing Address - Phone:727-398-5728
Mailing Address - Fax:727-398-4918
Practice Address - Street 1:8200 BRYAN DAIRY RD
Practice Address - Street 2:SUITE 340
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1363
Practice Address - Country:US
Practice Address - Phone:727-398-5728
Practice Address - Fax:727-398-4918
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1094231H00000X
FLAY1094237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33023OtherMEDICARE GROUP #
FLS2412OtherBC/BS
FL33023OtherMEDICARE GROUP #