Healthcare Provider Details

I. General information

NPI: 1366704504
Provider Name (Legal Business Name): HEARING HEALTHCARE SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 S AMELIA AVE #B
DELAND FL
32724-5564
US

IV. Provider business mailing address

1751 BLUE RIDGE RD
WINTER PARK FL
32789-5826
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-3322
  • Fax:
Mailing address:
  • Phone: 239-218-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberAS3404
License Number StateFL

VIII. Authorized Official

Name: MATTHEW CRAIG PAVONE
Title or Position: OWNER
Credential: BC-HIS, HAS
Phone: 239-218-0441