Healthcare Provider Details

I. General information

NPI: 1295788719
Provider Name (Legal Business Name): COASTAL HEARING CARE PROVIDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 US HIGHWAY 1
VERO BEACH FL
32960-5482
US

IV. Provider business mailing address

2045 US HIGHWAY 1
VERO BEACH FL
32960-5482
US

V. Phone/Fax

Practice location:
  • Phone: 772-778-3448
  • Fax: 772-778-7838
Mailing address:
  • Phone: 772-778-3448
  • Fax: 772-778-7838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: JANINE SNYDER
Title or Position: MANAGING MEMBER
Credential: HIS
Phone: 772-321-8270