Healthcare Provider Details

I. General information

NPI: 1215994611
Provider Name (Legal Business Name): BETTY JANE HOADE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9711 COMMERCE CENTER CT STE 101
FORT MYERS FL
33908-3817
US

IV. Provider business mailing address

19451 MEREDITH RD
NORTH FORT MYERS FL
33917-4819
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-0721
  • Fax: 239-939-3875
Mailing address:
  • Phone: 239-936-0721
  • Fax: 239-939-3875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY397
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: