Provider Demographics
NPI:1487109880
Name:THE HEARING DOCTOR, INC.
Entity type:Organization
Organization Name:THE HEARING DOCTOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAESTLE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:850-626-4327
Mailing Address - Street 1:5851 BERRYHILL RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-8279
Mailing Address - Country:US
Mailing Address - Phone:850-626-4327
Mailing Address - Fax:850-626-4387
Practice Address - Street 1:5851 BERRYHILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-8279
Practice Address - Country:US
Practice Address - Phone:850-626-4327
Practice Address - Fax:850-626-4387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1025231HA2400X, 231HA2500X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ8099OtherBLUECROSS BLUESHIELD OF FLORIDA
FL06636OtherHEARUSA