Healthcare Provider Details
I. General information
NPI: 1457812174
Provider Name (Legal Business Name): SEBRING MEDICAL HEARING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 US HIGHWAY 27 S
SEBRING FL
33870-2105
US
IV. Provider business mailing address
4119 SUN N LAKE BLVD
SEBRING FL
33872-2131
US
V. Phone/Fax
- Phone: 512-970-0384
- Fax:
- Phone: 512-970-0384
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
L
REINSHUTTLE
Title or Position: OWNER
Credential: BC-HIS
Phone: 512-970-0384