MEDICARE: GULF GATE HEARING AID CENTERS

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	R550559751320	FL

General Provider Information

NPI Number	:	1346439445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF GATE HEARING AID CENTERS

Provider Business Mailing Address
First Line	:	2170 GULF GATE DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-4813
Country	:	US
Telephone Number	:	941-922-5894
Fax Number	:

Provider Business Practice Location Address
First Line	:	2170 GULF GATE DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-4813
Country	:	US
Telephone Number	:	941-922-5894
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARK W. RAHMAN
Credential	:
Telephone Number	:	941-922-5894

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	10/15/2007

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