MEDICARE: LAROSE AUDIOLOGY 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
1	237600000X	Audiologist-Hearing Aid Fitter

General Provider Information

NPI Number	:	1710879051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAROSE AUDIOLOGY LLC

Provider Business Mailing Address
First Line	:	58 CARSON VALLEY WAY
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87508-1443
Country	:	US
Telephone Number	:	505-297-9574
Fax Number	:

Provider Business Practice Location Address
First Line	:	2945 RODEO PARK DR E UNIT 1A
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6312
Country	:	US
Telephone Number	:	505-297-9574
Fax Number	:

Authorized Official
Title or Position	:	AUDIOLOGIST OWNER
Name	:	ROGER WALTER LAROSE
Credential	:	M.A.
Telephone Number	:	505-297-9574

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/21/2025

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