Healthcare Provider Details

I. General information

NPI: 1588181648
Provider Name (Legal Business Name): JAKE ROBERT NUFFER AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 N FEDERAL HWY
FORT LAUDERDALE FL
33304-1422
US

IV. Provider business mailing address

1005 N FEDERAL HWY
FORT LAUDERDALE FL
33304-1422
US

V. Phone/Fax

Practice location:
  • Phone: 954-271-8006
  • Fax: 954-271-8022
Mailing address:
  • Phone: 954-271-8006
  • Fax: 954-271-8022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number869
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY2322
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: