Healthcare Provider Details

I. General information

NPI: 1902973530
Provider Name (Legal Business Name): SPEECH & HEARING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12627 SAN JOSE BLVD SUITE 503
JACKSONVILLE FL
32223-2662
US

IV. Provider business mailing address

12627 SAN JOSE BLVD SUITE 503
JACKSONVILLE FL
32223-2662
US

V. Phone/Fax

Practice location:
  • Phone: 904-355-3403
  • Fax: 904-355-4149
Mailing address:
  • Phone: 904-355-3403
  • Fax: 904-355-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DAWN STRAUSSER
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 904-355-3403