Healthcare Provider Details

I. General information

NPI: 1578601514
Provider Name (Legal Business Name): ANDREW P. TUBERTINI AU.D., CCC-A, AAA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
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 TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number0983A
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0983A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: