MEDICARE: ACTIVE LIFE AUDIOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter
2	231H00000X	Audiologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053774042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE LIFE AUDIOLOGY INC

Provider Business Mailing Address
First Line	:	8903 GLADES RD STE A-14A
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-4074
Country	:	US
Telephone Number	:	561-221-0450
Fax Number	:	561-423-4084

Provider Business Practice Location Address
First Line	:	8903 GLADES RD STE A14
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-4023
Country	:	US
Telephone Number	:	561-221-0450
Fax Number	:	954-827-0591

Authorized Official
Title or Position	:	AUDIOLOGIST AND OWNER
Name	:	MICHANNE ALEXIS DAVIDSON
Credential	:	AU.D.
Telephone Number	:	561-221-0450

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	11/09/2023

Similar Medicare Providers

1871452698 — AWELE ENWEMNWA
Practice Location Address:

8903 GLADES RD STE A8
BOCA RATON, FL
33434-4023

Practice Phone: 800-505-2913
Practice Fax:

1457210122 — DR. JOAN MORTON PHD, LCCC, LCPC
Practice Location Address:

8903 GLADES RD STE A8
BOCA RATON, FL
33434-4023

Practice Phone: 786-521-2728
Practice Fax:

1336172493 — DR. IRA BERMAN O.D.
Practice Location Address:

8903 GLADES RD STE A14
BOCA RATON, FL
33434-4023

Practice Phone: 561-477-3524
Practice Fax: 618-700-1235

1235283177 — DR. ROBERT J. MILLER D.M.D.
Practice Location Address:

8903 GLADES RD STE D6
BOCA RATON, FL
33434-4023

Practice Phone: 567-451-4343
Practice Fax: 561-852-4369

1487835062 — DR. RUSLANA VEKSLER PHARMD
Practice Location Address:

8903 GLADES RD STE D1
BOCA RATON, FL
33434-4023

Practice Phone: 917-309-5062
Practice Fax:

1376857441 — DR. MARIANGEL FERNANDEZ-MARTINEZ D.M.D
Practice Location Address:

8903 GLADES RD STE A7
BOCA RATON, FL
33434-4023

Practice Phone: 352-727-8547
Practice Fax:

Directions to “ACTIVE LIFE AUDIOLOGY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.