Provider Demographics
NPI:1396991949
Name:ADVANCED DIAGNOSTICS & HEARING SOLUTIONS LLC
Entity type:Organization
Organization Name:ADVANCED DIAGNOSTICS & HEARING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A, F-AAA
Authorized Official - Phone:813-315-9850
Mailing Address - Street 1:522 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5743
Mailing Address - Country:US
Mailing Address - Phone:813-315-9850
Mailing Address - Fax:813-315-9837
Practice Address - Street 1:522 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5743
Practice Address - Country:US
Practice Address - Phone:813-315-9850
Practice Address - Fax:813-315-9837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY-1204231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty