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NPI Code Detail

MEDICARE: JENNILYN FINCH HIS

MEDICARE: JENNILYN FINCH HIS
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
1237700000XHearing Instrument SpecialistAS5152FL

General Provider Information

NPI Number : 1992160469
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNILYN FINCH HIS
Provider Business Mailing Address
First Line : 1106 W NEW HAVEN AVE
Second Line :
City : MELBOURNE
State : FL
Zip : 32904-4056
Country : US
Telephone Number : 321-914-0810
Fax Number : 321-914-0821
Provider Business Practice Location Address
First Line : 1106 W NEW HAVEN AVE
Second Line :
City : MELBOURNE
State : FL
Zip : 32904-4056
Country : US
Telephone Number : 321-914-0810
Fax Number : 321-914-0821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2015
Last Update Date : 12/28/2015

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