MEDICARE: BRITTANY KOMES AU.D.

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	231H00000X	Audiologist	AY 2006	FL

General Provider Information

NPI Number	:	1093172660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY KOMES AU.D.

Provider Business Mailing Address
First Line	:	39 BARKLEY CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	43 BARKLEY CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-4510
Country	:	US
Telephone Number	:	239-936-1616
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2016
Last Update Date	:	03/24/2016

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