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General NPI Number Information
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NPI Number | 1669658415
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Entity Type | Organization
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Legal Business Name | PELICAN BAY HEARING CARE, INC.
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 5600 TRAIL BLVD SUITE 16
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City | NAPLES
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State | FL
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Zip | 34108-2880
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Country | US
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Telephone | 239-566-2727
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Fax | 239-463-7149
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Provider Business Mailing Address
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Address Line | 5600 TRAIL BLVD SUITE 16
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City | NAPLES
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State | FL
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Zip | 34108-2880
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Country | US
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Telephone | 239-566-2727
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Fax | 239-463-7149
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. IRENA R RDZANEK
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Credential |
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Telephone | 239-566-2727
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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 | AY 77
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AY 77
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License Number State | FL
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