Basic Information
| Provider Information | |||||||||
| NPI: | 1457626418 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEFL, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 204 WOODHEW DR | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767126529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542275189 | ||||||||
| FaxNumber: | 2543004990 | ||||||||
| Practice Location | |||||||||
| Address1: | 3055 COLUMBIA BLVD STE B107 | ||||||||
| Address2: | |||||||||
| City: | TITUSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327807865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212679746 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2012 | ||||||||
| LastUpdateDate: | 08/28/2020 | ||||||||
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| AuthorizedOfficialLastName: | CARROLL | ||||||||
| AuthorizedOfficialFirstName: | KENNY LYNN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2542275189 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.