MEDICARE: NORTHERN AUDIOLOGY ASSOCIATES INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J8041	OTHER	FL	BLUE CROSS BLUE SHIELD
2	2497667	OTHER	FL	AETNA HMO NUMBER

General Provider Information

NPI Number	:	1518988773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN AUDIOLOGY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	1325 S CONGRESS AVE
Second Line	:	STE. 107
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5876
Country	:	US
Telephone Number	:	561-742-7559
Fax Number	:	561-742-7957

Provider Business Practice Location Address
First Line	:	1325 S CONGRESS AVE
Second Line	:	STE. 107
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5876
Country	:	US
Telephone Number	:	561-742-7559
Fax Number	:	561-742-7957

Authorized Official
Title or Position	:	PARTNER/AUDIOLOGIST
Name	:	MS. ELLEN SLOAN
Credential	:	M.S.,CCC-A
Telephone Number	:	561-742-7559

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	03/23/2015

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Directions to “NORTHERN AUDIOLOGY ASSOCIATES INC ” Practice Location

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