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NPI Code Detail

MEDICARE: OCEANSIDE AUDIOLOGY & HEARING LLC

MEDICARE: OCEANSIDE AUDIOLOGY & HEARING LLC
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
1261QH0700XHearing and Speech Clinic/Center
2332S00000XHearing Aid Equipment
3231H00000XAudiologist

General Provider Information

NPI Number : 1225605447
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCEANSIDE AUDIOLOGY & HEARING LLC
Provider Business Mailing Address
First Line : 1005 N FEDERAL HWY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-1422
Country : US
Telephone Number : 954-271-8006
Fax Number : 954-271-8022
Provider Business Practice Location Address
First Line : 1005 N FEDERAL HWY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-1422
Country : US
Telephone Number : 954-271-8006
Fax Number : 954-271-8022
Authorized Official
Title or Position : OWNER
Name : DR. WILLIAM J ROACH
Credential : AU.D.
Telephone Number : 954-271-8006
Provider Enumeration Date : 06/07/2021
Last Update Date : 06/07/2021

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Directions to “OCEANSIDE AUDIOLOGY & HEARING LLC ” Practice Location

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