Healthcare Provider Details

I. General information

NPI: 1033701073
Provider Name (Legal Business Name): WAYNE ARMONDI HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2269 BLANDING BLVD
JACKSONVILLE FL
32210-4100
US

IV. Provider business mailing address

2269 BLANDING BLVD
JACKSONVILLE FL
32210-4100
US

V. Phone/Fax

Practice location:
  • Phone: 904-389-8333
  • Fax: 904-389-8331
Mailing address:
  • Phone: 904-389-8333
  • Fax: 904-389-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS2198
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS4415
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: