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General NPI Number Information
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NPI Number | 1518002732
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Entity Type | Organization
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Legal Business Name | SOUTHWEST FLORIDA CENTER FOR HEARING AND BALANCE P A
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 9732 COMMERCE CENTER CT UNIT A
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City | FORT MYERS
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State | FL
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Zip | 33908-3647
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Country | US
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Telephone | 239-332-0707
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Fax | 239-332-0780
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Provider Business Mailing Address
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Address Line | 9732 COMMERCE CENTER CT UNIT A
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City | FORT MYERS
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State | FL
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Zip | 33908-3647
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Country | US
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Telephone | 239-332-0707
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Fax | 239-332-0780
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Authorized Official
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Title or Position | PRESIDENT
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Name | LYNDA MARIE NALLY
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Credential | AUD
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Telephone | 239-332-0707
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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 |
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License Number State |
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