Healthcare Provider Details

I. General information

NPI: 1730219841
Provider Name (Legal Business Name): AUDIOLOGY CONSULTANTS OF BOYNTON BEACH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7593 BOYNTON BEACH BLVD SUITE 160
BOYNTON BEACH FL
33437-6154
US

IV. Provider business mailing address

7593 BOYNTON BEACH BLVD SUITE 160
BOYNTON BEACH FL
33437-6154
US

V. Phone/Fax

Practice location:
  • Phone: 561-742-9880
  • Fax: 561-742-5990
Mailing address:
  • Phone: 561-742-9880
  • Fax: 561-742-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY981
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberAY981
License Number StateFL

VIII. Authorized Official

Name: DR. ADAM LOCKER
Title or Position: OWNER AUDIOLOGIST
Credential: AU.D.
Phone: 561-742-9880