Basic Information
Provider Information
NPI: 1174895023
EntityType: 2
ReplacementNPI:  
OrganizationName: MEFL, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: SEARS HEARING AID CENTER - PALM BEACH GARDENS
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 204 WOODHEW DR
Address2:  
City: WACO
State: TX
PostalCode: 767126529
CountryCode: US
TelephoneNumber: 2545374422
FaxNumber: 2543004619
Practice Location
Address1: 5540 PGA BLVD STE 102
Address2:  
City: PALM BEACH GARDENS
State: FL
PostalCode: 334183987
CountryCode: US
TelephoneNumber: 5616309350
FaxNumber: 5617761205
Other Information
ProviderEnumerationDate: 02/07/2012
LastUpdateDate: 07/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: KEY
AuthorizedOfficialFirstName: STEVE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: COO
AuthorizedOfficialTelephone: 2542275189
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X  Y193400000X SINGLE SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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