Provider Demographics
NPI:1174742761
Name:MUSCATO, NANCY J (AUD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:MUSCATO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:MUSCATO
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4202 E FOWLER AVE
Practice Address - Street 2:PCD1017
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33620-8150
Practice Address - Country:US
Practice Address - Phone:813-974-8804
Practice Address - Fax:813-974-0822
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY533237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886345801Medicaid
FLS00JMOtherBLUE CROSS BLUE SHIELD
FL886345800Medicaid
FL886345801Medicaid