MEDICARE: MR. MICHAEL T. DEHLER BS, HAS, BC-HIS, ACA

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	AS3297	FL

General Provider Information

NPI Number	:	1376874545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL T. DEHLER BS, HAS, BC-HIS, ACA

Provider Business Mailing Address
First Line	:	1130 W GRANADA BLVD
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5913
Country	:	US
Telephone Number	:	386-672-9993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 W GRANADA BLVD
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5913
Country	:	US
Telephone Number	:	386-672-9993
Fax Number	:

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

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	01/27/2010

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