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General NPI Number Information
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NPI Number | 1033512389
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Entity Type | Individual
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Provider Name | ROBERT J PAVONE BC-HIS, HAS
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Gender | Male
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 11/22/2017
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Provider Practice Location Address
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Address Line | 2601 WEST LAKE MARY BLVD SUITE 109
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City | LAKE MARY
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State | FL
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Zip | 32746-2527
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Country | US
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Telephone | 407-804-0333
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Fax | 407-804-0353
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Provider Business Mailing Address
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Address Line | 1751 BLUE RIDGE ROAD
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City | WINTER PARK
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State | FL
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Zip | 32789
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Country | US
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Telephone | 407-601-5798
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Fax | 407-286-3186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS3920
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License Number State | FL
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