Healthcare Provider Details

I. General information

NPI: 1982004768
Provider Name (Legal Business Name): BEN KALEKY HAS, BCHIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 S FLORIDA AVE SUITE 1240
LAKELAND FL
33803-4876
US

IV. Provider business mailing address

224 WREN AVE
SEBRING FL
33870-8555
US

V. Phone/Fax

Practice location:
  • Phone: 863-797-4520
  • Fax:
Mailing address:
  • Phone: 863-273-1518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS2803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: