Healthcare Provider Details

I. General information

NPI: 1750758942
Provider Name (Legal Business Name): AKSUN HEARING CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 N US HIGHWAY 1 STE 11
TEQUESTA FL
33469-3241
US

IV. Provider business mailing address

1620 N US HIGHWAY 1 STE 11
TEQUESTA FL
33469-3241
US

V. Phone/Fax

Practice location:
  • Phone: 561-341-0229
  • Fax: 561-250-6986
Mailing address:
  • Phone: 561-341-0229
  • Fax: 561-250-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. SRIKANTH DORAISWAMY
Title or Position: OWENER PRESIDENT
Credential:
Phone: 561-341-0229