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General NPI Number Information
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NPI Number | 1528275328
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Entity Type | Organization
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Legal Business Name | FLAGLER HEARING SERVICES, INC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 HEALTH PARK BLVD SUITE 323
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5793
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Country | US
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Telephone | 386-826-1899
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Fax | 386-829-2452
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Provider Business Mailing Address
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Address Line | 4 WEYBURH PL
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City | PALM COAST
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State | FL
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Zip | 32164-7732
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Country | US
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Telephone | 386-299-5144
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Fax | 386-672-9993
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | MR. FRANK J. FAVARO
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Credential | CCC-A
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Telephone | 386-299-5144
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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 | AY216
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License Number State | FL
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