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General NPI Number Information
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NPI Number | 1891247821
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Entity Type | Organization
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Legal Business Name | JAX AUDIOLOGY & HEARING AID CENTER, INC.
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 150 WARREN CIR SUITE 5A
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City | SAINT JOHNS
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State | FL
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Zip | 32259-3845
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Country | US
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Telephone | 404-697-7255
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Fax |
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Provider Business Mailing Address
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Address Line | 150 WARREN CIR SUITE 5A
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City | SAINT JOHNS
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State | FL
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Zip | 32259-3845
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LESLIE ANN NEWMEYER
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Credential | AUD.
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Telephone | 404-697-7255
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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 | AY1663
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License Number State | FL
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