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General NPI Number Information
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NPI Number | 1851615231
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Entity Type | Individual
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Provider Name | BENGT ERICSSON B.C.-H.I.S.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 03/15/2010
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Provider Practice Location Address
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Address Line | 1719 LAKEWOOD RANCH BLVD
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City | BRADENTON
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State | FL
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Zip | 34211-4906
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Country | US
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Telephone | 941-744-0900
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Fax | 941-744-0925
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Provider Business Mailing Address
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Address Line | 1719 LAKEWOOD RANCH BLVD
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City | BRADENTON
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State | FL
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Zip | 34211-4906
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Country | US
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Telephone | 941-744-0900
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Fax | 941-744-0925
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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 | AS3904
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License Number State | FL
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