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General NPI Number Information
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NPI Number | 1275721508
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Entity Type | Organization
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Legal Business Name | FLORIDA STATE HEARING AIDS INC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 1808 WEST INTERNATIONAL SPEEDWAY BLVD SUITE 305
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1227
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Country | US
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Telephone | 386-226-0007
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Fax | 386-226-3037
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Provider Business Mailing Address
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Address Line | 1808 WEST INTERNATIONAL SPEEDWAY BLVD SUITE 305
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1227
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Country | US
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Telephone | 386-226-0007
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Fax | 386-226-3037
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Authorized Official
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Title or Position | OWNER
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Name | MS. JULIE PRUITT
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Credential | FL LHAS HIS AS2626
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Telephone | 386-226-0007
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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 | AS2626
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License Number State | FL
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