MEDICARE: MIRACLE-EAR, INC.

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	237600000X	Audiologist-Hearing Aid Fitter

General Provider Information

NPI Number	:	1861625576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRACLE-EAR, INC.

Provider Business Mailing Address
First Line	:	5000 CHESHIRE PKWY N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55446-4103
Country	:	US
Telephone Number	:	763-268-4084
Fax Number	:	763-268-4240

Provider Business Practice Location Address
First Line	:	3103 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2801
Country	:	US
Telephone Number	:	561-625-4514
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	PAUL M. D'AMICO
Credential	:
Telephone Number	:	888-510-0766

Provider Enumeration Date	:	08/27/2009
Last Update Date	:	08/27/2009

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Directions to “MIRACLE-EAR, INC. ” Practice Location

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