Provider Demographics
NPI:1194912329
Name:EAR-TRONICS, INC
Entity type:Organization
Organization Name:EAR-TRONICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-275-7655
Mailing Address - Street 1:7181 COLLEGE PKWY
Mailing Address - Street 2:SUITE 14
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5669
Mailing Address - Country:US
Mailing Address - Phone:239-275-7655
Mailing Address - Fax:239-275-6889
Practice Address - Street 1:7181 COLLEGE PKWY
Practice Address - Street 2:SUITE 14
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5669
Practice Address - Country:US
Practice Address - Phone:239-275-7655
Practice Address - Fax:239-275-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY248231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5135AMedicare PIN