MEDICARE: MR. JOHN H. ADAMS M.S., CCC-A

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	231H00000X	Audiologist	AY-274	FL
2	237600000X	Audiologist-Hearing Aid Fitter	AY-274	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S0637	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1972593796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN H. ADAMS M.S., CCC-A

Provider Business Mailing Address
First Line	:	15721 NEW HAMPSHIRE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-4176
Country	:	US
Telephone Number	:	239-481-2088
Fax Number	:	239-481-2095

Provider Business Practice Location Address
First Line	:	15721 NEW HAMPSHIRE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-4176
Country	:	US
Telephone Number	:	239-481-2088
Fax Number	:	239-481-2095

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	07/01/2020

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