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General NPI Number Information
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NPI Number | 1922370485
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Entity Type | Organization
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Legal Business Name | BAYSIDE HEARING AID CENTER INC
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 16450 SAN CARLOS BLVD STE 3
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City | FORT MYERS
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State | FL
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Zip | 33908-3271
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Country | US
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Telephone | 239-415-0727
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Fax | 239-288-4915
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Provider Business Mailing Address
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Address Line | 16450 SAN CARLOS BLVD STE 3
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City | FORT MYERS
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State | FL
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Zip | 33908-3271
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Country | US
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Telephone | 239-415-0727
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Fax | 239-288-4915
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELEANOR R WINN
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Credential | AS BCHIS ACA
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Telephone | 239-415-0727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | AS2687
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License Number State | FL
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