Healthcare Provider Details

I. General information

NPI: 1053178384
Provider Name (Legal Business Name): INDIAN RIVER HEARING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 22ND PL
VERO BEACH FL
32960-6002
US

IV. Provider business mailing address

491 22ND PL
VERO BEACH FL
32960-6002
US

V. Phone/Fax

Practice location:
  • Phone: 772-978-9880
  • Fax: 772-365-3965
Mailing address:
  • Phone: 772-978-9880
  • Fax: 772-365-3965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KEVIN MCCURDY
Title or Position: OWNER
Credential: H.A.S.
Phone: 772-978-9880