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NPI Code Detail

MEDICARE: KELLY HERNANDEZ AUDIOLOGIST

MEDICARE: KELLY HERNANDEZ AUDIOLOGIST
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
1231H00000XAudiologist51246TX
2231HA2400XAssistive Technology Practitioner Audiologist51246TX
3237600000XAudiologist-Hearing Aid Fitter51246TX
4237600000XAudiologist-Hearing Aid FitterDA5812AZ

General Provider Information

NPI Number : 1366595514
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY HERNANDEZ AUDIOLOGIST
Provider Business Mailing Address
First Line : 9097 E DESERT COVE AVE
Second Line : 260
City : SCOTTSDALE
State : AZ
Zip : 85260-6279
Country : US
Telephone Number : 480-273-8510
Fax Number : 480-214-9933
Provider Business Practice Location Address
First Line : 225 S DOBSON RD
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-6274
Country : US
Telephone Number : 480-558-5306
Fax Number : 480-558-5307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 12/29/2016

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Directions to “ KELLY HERNANDEZ AUDIOLOGIST” Practice Location

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