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General NPI Number Information
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NPI Number | 1386967438
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Entity Type | Organization
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Legal Business Name | CDPA, INC
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 8112 CENTRALIA CT SUITE 104
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City | LEESBURG
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State | FL
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Zip | 34788-3700
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Country | US
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Telephone | 352-360-0554
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Fax | 352-360-1788
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Provider Business Mailing Address
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Address Line | 8112 CENTRALIA CT SUITE 104
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City | LEESBURG
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State | FL
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Zip | 34788-3700
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Country | US
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Telephone | 352-360-0554
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Fax | 352-360-1788
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Authorized Official
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Title or Position | OWNER/HEARING INSTRUMENT SPECIALIST
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Name | MR. DARRICK T AYNES
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Credential | HIS
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Telephone | 352-360-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | AS4310
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License Number State | FL
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