Provider Demographics
NPI:1194084467
Name:SOUTHWEST FLORIDA TINNITUS AND HEARING CENTER
Entity type:Organization
Organization Name:SOUTHWEST FLORIDA TINNITUS AND HEARING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:HOGLUND
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS, ACA
Authorized Official - Phone:239-498-7142
Mailing Address - Street 1:10020 COCONUT RD
Mailing Address - Street 2:SUITE120
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-8124
Mailing Address - Country:US
Mailing Address - Phone:239-992-4327
Mailing Address - Fax:239-498-4520
Practice Address - Street 1:10020 COCONUT RD
Practice Address - Street 2:SUITE120
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-8124
Practice Address - Country:US
Practice Address - Phone:239-992-4327
Practice Address - Fax:239-498-4520
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOGLUND FAMILY HEARING, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment