Healthcare Provider Details

I. General information

NPI: 1285336784
Provider Name (Legal Business Name): SOUTHEAST HEARING PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9156 SEMINOLE BLVD
SEMINOLE FL
33772-3148
US

IV. Provider business mailing address

851 BROKEN SOUND PKWY NW STE 120
BOCA RATON FL
33487-3638
US

V. Phone/Fax

Practice location:
  • Phone: 727-393-3775
  • Fax: 561-299-5438
Mailing address:
  • Phone: 561-367-1623
  • Fax: 561-299-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LEAH MANOR
Title or Position: CORPORATE INSURANCE MANAGER
Credential:
Phone: 561-367-1623