MEDICARE: KENNETH ANTHONY FREIA H.A.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	AS2708	FL

General Provider Information

NPI Number	:	1134595481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH ANTHONY FREIA H.A.S.

Provider Business Mailing Address
First Line	:	2900 W SAMPLE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33073-3024
Country	:	US
Telephone Number	:	954-975-5756
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 W SAMPLE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33073-3024
Country	:	US
Telephone Number	:	954-975-5756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2015
Last Update Date	:	08/20/2015

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