Basic Information
| Provider Information | |||||||||
| NPI: | 1730219841 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AUDIOLOGY CONSULTANTS OF BOYNTON BEACH INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HEARFLORIDA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7593 BOYNTON BEACH BLVD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334376154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617429880 | ||||||||
| FaxNumber: | 5617425990 | ||||||||
| Practice Location | |||||||||
| Address1: | 7593 BOYNTON BEACH BLVD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334376154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617429880 | ||||||||
| FaxNumber: | 5617425990 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2007 | ||||||||
| LastUpdateDate: | 06/09/2009 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | LOCKER | ||||||||
| AuthorizedOfficialFirstName: | ADAM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER AUDIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 5617429880 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | AU.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | AY981 | FL | N | Suppliers | Hearing Aid Equipment | 231H00000X | AY981 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.