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General NPI Number Information
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NPI Number | 1326051079
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA HEARING SERVICES
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1224 N PEACOCK AVE
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City | PERRY
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State | FL
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Zip | 32347-2117
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Country | US
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Telephone | 859-584-3277
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Fax | 850-584-4738
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Provider Business Mailing Address
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Address Line | 1224 N PEACOCK AVE
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City | PERRY
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State | FL
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Zip | 32347-2117
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Country | US
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Telephone | 859-584-3277
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Fax | 850-584-4738
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY D. RUSSELL
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Credential | AU.D.
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Telephone | 850-584-3277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | AY941
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License Number State | FL
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