MEDICARE: BETTER HEARING CENTERS OF FLORIDA

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	AS3776	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	T0902	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1760629505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETTER HEARING CENTERS OF FLORIDA

Provider Business Mailing Address
First Line	:	2701 CLEVELAND AVE STE D
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-5800
Country	:	US
Telephone Number	:	239-461-9321
Fax Number	:	239-461-5354

Provider Business Practice Location Address
First Line	:	2701 CLEVELAND AVE STE D
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-5800
Country	:	US
Telephone Number	:	239-461-9321
Fax Number	:	239-461-5354

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM BREAKSTONE
Credential	:	H.I.S
Telephone Number	:	239-495-2158

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	08/04/2009

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