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General NPI Number Information
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NPI Number | 1740799469
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Entity Type | Individual
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Provider Name | FRANK SEVERINO
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Gender | Male
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 2108 PARK AVE STE 108
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City | ORANGE PARK
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State | FL
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Zip | 32073-5589
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Country | US
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Telephone | 904-375-0658
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Fax |
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Provider Business Mailing Address
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Address Line | 4765 HODGES BLVD STE 14
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City | JACKSONVILLE
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State | FL
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Zip | 32224-5279
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Country | US
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Telephone | 604-516-4149
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Fax | 604-516-4150
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5249
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License Number State | FL
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