Healthcare Provider Details

I. General information

NPI: 1245112812
Provider Name (Legal Business Name): ACUITY RETAIL WHALEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CYPRESS POINT PKWY STE A108
PALM COAST FL
32164-8438
US

IV. Provider business mailing address

160 CYPRESS POINT PKWY STE A108
PALM COAST FL
32164-8438
US

V. Phone/Fax

Practice location:
  • Phone: 386-585-4161
  • Fax: 386-649-7711
Mailing address:
  • Phone: 386-585-4161
  • Fax: 386-649-7711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: REBECCA MEASELLS
Title or Position: ADMINISTRATOR
Credential:
Phone: 512-584-9586