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General NPI Number Information
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NPI Number | 1447507322
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Entity Type | Organization
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Legal Business Name | FRESHEARING LLC
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 5143 SW 129TH TER
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City | MIRAMAR
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State | FL
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Zip | 33027-5837
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Country | US
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Telephone | 305-439-4292
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Fax |
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Provider Business Mailing Address
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Address Line | 5143 SW 129TH TER
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City | MIRAMAR
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State | FL
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Zip | 33027-5837
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Country | US
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Telephone | 305-439-4292
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF AUDIOLOGY/CEO
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Name | DR. RENEE T NEELY
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Credential | AU.D.
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Telephone | 305-439-4292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY1006
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License Number State | FL
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