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	:	1922279868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRACLE-EAR, INC.

Provider Business Mailing Address
First Line	:	5000 CHESHIRE LN N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55446-3706
Country	:	US
Telephone Number	:	888-333-9152
Fax Number	:

Provider Business Practice Location Address
First Line	:	3655 SW 22ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3014
Country	:	US
Telephone Number	:	305-460-3425
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	PAUL M D'AMICO
Credential	:
Telephone Number	:	888-333-9152

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	08/27/2009

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

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