Basic Information
| Provider Information | |||||||||
| NPI: | 1699183269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TROCONIS | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | H.I.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12193 PEMBROKE ROAD | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544358820 | ||||||||
| FaxNumber: | 9544508185 | ||||||||
| Practice Location | |||||||||
| Address1: | 12193 PEMBROKE RD | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330251727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544358820 | ||||||||
| FaxNumber: | 9544508185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2014 | ||||||||
| LastUpdateDate: | 07/28/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | A.S. 4557 | FL | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.