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General NPI Number Information
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NPI Number | 1770062978
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Entity Type | Organization
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Legal Business Name | LIFE HEARING & AUDIOLOGY CLINICS LLC
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 923 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33990
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Country | US
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Telephone | 239-984-2619
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Fax |
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Provider Business Mailing Address
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Address Line | 720 N GOODLETTE RD #200
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City | NAPLES
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State | FL
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Zip | 34102
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Country | US
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Telephone | 239-649-5433
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Fax |
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Authorized Official
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Title or Position | SPECIALIST
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Name | MR. DONALD R KLEINDL III
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Credential | HAS, BC-HHS, ACA
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Telephone | 239-649-5433
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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 | AS4986
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License Number State | FL
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