Healthcare Provider Details

I. General information

NPI: 1104736750
Provider Name (Legal Business Name): MIGELINO US INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 SW FOUNTAINVIEW BLVD STE 63
PORT ST LUCIE FL
34986-4535
US

IV. Provider business mailing address

11582 SW VILLAGE PKWY UNIT 582
PORT ST LUCIE FL
34987-2392
US

V. Phone/Fax

Practice location:
  • Phone: 614-705-0215
  • Fax:
Mailing address:
  • Phone: 614-705-0214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHENEEKRA ADAMS
Title or Position: CHIEF AUDIOLOGY OFFICER
Credential: AUD
Phone: 614-705-0214