Healthcare Provider Details

I. General information

NPI: 1205226289
Provider Name (Legal Business Name): COASTAL HEARING AND BALANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2015
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LOTTIE LN STE 2
FAIRHOPE AL
36532-7309
US

IV. Provider business mailing address

101 LOTTIE LN STE 2
FAIRHOPE AL
36532-7309
US

V. Phone/Fax

Practice location:
  • Phone: 251-990-0535
  • Fax: 251-990-0538
Mailing address:
  • Phone: 251-990-0535
  • Fax: 251-990-0538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW P TUBERTINI
Title or Position: OWNER
Credential: AU.D.
Phone: 251-550-6514