MEDICARE: AUDIOLOGY ASSOCIATES OF SOUTH FLORIDA 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	AY24	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952471732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUDIOLOGY ASSOCIATES OF SOUTH FLORIDA INC.

Provider Business Mailing Address
First Line	:	5411 N UNIVERSITY DR
Second Line	:	SUITE 102
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4637
Country	:	US
Telephone Number	:	954-752-1559
Fax Number	:	954-752-1560

Provider Business Practice Location Address
First Line	:	5411 N UNIVERSITY DR
Second Line	:	SUITE 102
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4637
Country	:	US
Telephone Number	:	954-752-1559
Fax Number	:	954-752-1560

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ROBERTA RANDEL
Credential	:	AUD
Telephone Number	:	954-752-1559

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	03/09/2009

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