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General NPI Number Information
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NPI Number | 1881649309
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Entity Type | Organization
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Legal Business Name | CSB AUDIO REHABILITATION INC.
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 3261 HWY 27-441 BLDG C STE C3
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City | FRUITLAND PARK
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State | FL
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Zip | 34731
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Country | US
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Telephone | 352-360-0500
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Fax | 352-360-0555
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Provider Business Mailing Address
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Address Line | 3261 HWY 27/441
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City | FRUITLAND PARK
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State | FL
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Zip | 34731-4497
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Country | US
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Telephone | 352-360-0500
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Fax | 352-360-0555
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MRS. SHARON I BLACKMAN
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Credential | BC-HIS, ACA
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Telephone | 352-589-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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