Healthcare Provider Details

I. General information

NPI: 1417553223
Provider Name (Legal Business Name): ADOBE HEARING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20325 N 51ST AVE STE 156
GLENDALE AZ
85308-4622
US

IV. Provider business mailing address

20325 N 51ST AVE STE 156
GLENDALE AZ
85308-4622
US

V. Phone/Fax

Practice location:
  • Phone: 623-900-4740
  • Fax: 623-900-4741
Mailing address:
  • Phone: 623-900-4740
  • Fax: 623-900-4741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL RENE RODRIGUEZ
Title or Position: PRESIDENT
Credential: DO
Phone: 623-900-4740