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NPI Code Detail

MEDICARE: MR. EDGAR MENFUG MOCK

MEDICARE:  MR. EDGAR MENFUG MOCK
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
1237700000XHearing Instrument Specialist3110FL

General Provider Information

NPI Number : 1407942154
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDGAR MENFUG MOCK
Provider Business Mailing Address
First Line : 2014 NE 164TH STREET
Second Line :
City : NO MIAMI BEACH
State : FL
Zip : 33162
Country : US
Telephone Number : 305-940-6714
Fax Number : 305-940-9514
Provider Business Practice Location Address
First Line : 2014 NE 164TH STREET
Second Line :
City : NO MIAMI BEACH
State : FL
Zip : 33162
Country : US
Telephone Number : 305-940-6714
Fax Number : 305-940-9514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 07/09/2007

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Directions to “ MR. EDGAR MENFUG MOCK ” Practice Location

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