Healthcare Provider Details

I. General information

NPI: 1598088015
Provider Name (Legal Business Name): AUDIO ADVANCED TECHNOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 10/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA DEGETAU AVE.PUERTO RICO ESQUINA DEGETAU STE 9 &10 PARQUE INDUSTRIAL DEL OESTE VALLE TOLIMA
CAGUAS PR
00725-0000
US

IV. Provider business mailing address

PLAZA DEGETAU AVE. PUERTO RICO ESQUINA DEGATAU SUITE 9&10
CAGUAS PR
00727-4992
US

V. Phone/Fax

Practice location:
  • Phone: 787-961-2009
  • Fax: 787-961-2020
Mailing address:
  • Phone: 787-961-2009
  • Fax: 787-961-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: WILFREDO RIVERA
Title or Position: HEARING AID SPECIALIST
Credential:
Phone: 787-961-2009