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General NPI Number Information
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NPI Number | 1598214371
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Entity Type | Organization
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Legal Business Name | FLORIDA REGIONAL CONSULTANTS
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 306 E NEW HAVEN AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-4506
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Country | US
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Telephone | 321-327-5922
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Fax |
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Provider Business Mailing Address
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Address Line | 306 E NEW HAVEN AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-4506
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Country | US
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Telephone | 321-327-5922
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Fax |
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Authorized Official
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Title or Position | OWNER/ CONSULANT
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Name | ROBERT J LAWLESS
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Credential | HAS
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Telephone | 321-327-5922
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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 | AS4885
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License Number State | FL
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