MEDICARE: ATLANTIC AUDIOLOGY, LLC

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	332S00000X	Hearing Aid Equipment
2	231H00000X	Audiologist

General Provider Information

NPI Number	:	1184093262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC AUDIOLOGY, LLC

Provider Business Mailing Address
First Line	:	3840 S NOVA RD STE B1
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-4244
Country	:	US
Telephone Number	:	386-756-8225
Fax Number	:	386-767-0742

Provider Business Practice Location Address
First Line	:	3840 S NOVA RD STE B1
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-4244
Country	:	US
Telephone Number	:	386-756-8225
Fax Number	:	386-767-0742

Authorized Official
Title or Position	:	OWNER
Name	:	FORREST CADE SIMPSON
Credential	:
Telephone Number	:	936-776-7028

Provider Enumeration Date	:	09/18/2015
Last Update Date	:	12/10/2025

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