MEDICARE: BELTONE ORLANDO, LLC

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	AS3349	FL

General Provider Information

NPI Number	:	1851725907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELTONE ORLANDO, LLC

Provider Business Mailing Address
First Line	:	931 JEFFERSON BLVD
Second Line	:	STE. 2001
City	:	WARWICK
State	:	RI
Zip	:	02886-2234
Country	:	US
Telephone Number	:	904-298-2855
Fax Number	:	904-298-2857

Provider Business Practice Location Address
First Line	:	990 N STATE ROAD 434
Second Line	:	SUITE 1144
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-7035
Country	:	US
Telephone Number	:	904-298-2855
Fax Number	:	904-298-2857

Authorized Official
Title or Position	:	INSURANCE MANAGER
Name	:	ANDREA BARBER
Credential	:
Telephone Number	:	904-298-2855

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	08/26/2013

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