Healthcare Provider Details

I. General information

NPI: 1154720621
Provider Name (Legal Business Name): GULF HEARING AID CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 08/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 TAMIAMI TRL N
NAPLES FL
34102-5803
US

IV. Provider business mailing address

380 TAMIAMI TRL N
NAPLES FL
34102-5803
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-2288
  • Fax:
Mailing address:
  • Phone: 239-262-2288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY497
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS1317
License Number StateFL

VIII. Authorized Official

Name: MRS. VIRGINIA TOMPKINS ROWLEDGE
Title or Position: OWNER
Credential: BC-HIS
Phone: 239-262-2288