Healthcare Provider Details

I. General information

NPI: 1972154342
Provider Name (Legal Business Name): 20/20 HEARING CARE NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 W CYPRESS CREEK RD STE 4
FORT LAUDERDALE FL
33309-1715
US

IV. Provider business mailing address

2900 W CYPRESS CREEK RD STE 4
FORT LAUDERDALE FL
33309-1715
US

V. Phone/Fax

Practice location:
  • Phone: 954-917-2337
  • Fax: 954-979-8988
Mailing address:
  • Phone: 954-917-2337
  • Fax: 954-979-8988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT COPPOLA
Title or Position: OWNER
Credential: OD
Phone: 954-917-2337