Healthcare Provider Details

I. General information

NPI: 1487109880
Provider Name (Legal Business Name): THE HEARING DOCTOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5851 BERRYHILL RD
MILTON FL
32570-8279
US

IV. Provider business mailing address

5851 BERRYHILL RD
MILTON FL
32570-8279
US

V. Phone/Fax

Practice location:
  • Phone: 850-626-4327
  • Fax: 850-626-4387
Mailing address:
  • Phone: 850-626-4327
  • Fax: 850-626-4387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1025
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAY1025
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License NumberAY1025
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY1025
License Number StateFL

VIII. Authorized Official

Name: SABRINA M KAESTLE
Title or Position: DIRECTOR
Credential: AU.D.
Phone: 850-626-4327