MEDICARE: MIRAMAR BEACH AUDIOLOGY ASSOCIATES

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	231H00000X	Audiologist

General Provider Information

NPI Number	:	1467347591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRAMAR BEACH AUDIOLOGY ASSOCIATES

Provider Business Mailing Address
First Line	:	1404 S STREET CAR PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-3951
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 BUSINESS CENTRE DR UNIT 306
Second Line	:
City	:	MIRAMAR BEACH
State	:	FL
Zip	:	32550-6995
Country	:	US
Telephone Number	:	605-306-3050
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUD
Name	:	MANDY ROUNSEVILLE
Credential	:
Telephone Number	:	605-306-3050

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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