MEDICARE: DR. WILLIAM JAMES ROACH 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	237700000X	Hearing Instrument Specialist
2	237600000X	Audiologist-Hearing Aid Fitter	AY1981	FL
3	231H00000X	Audiologist	AY1981	FL
4	237600000X	Audiologist-Hearing Aid Fitter

General Provider Information

NPI Number	:	1679942437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JAMES ROACH AU.D.

Provider Business Mailing Address
First Line	:	1005 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1422
Country	:	US
Telephone Number	:	549-271-8006
Fax Number	:	954-271-8022

Provider Business Practice Location Address
First Line	:	1005 N FEDERAL HWY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-1422
Country	:	US
Telephone Number	:	954-271-8006
Fax Number	:	954-271-8022

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

Provider Enumeration Date	:	09/22/2015
Last Update Date	:	07/08/2021

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