Provider Demographics
NPI:1891858577
Name:NEURO AUDIOLOGY CONSULTANTS LLC
Entity type:Organization
Organization Name:NEURO AUDIOLOGY CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MCD
Authorized Official - Phone:561-393-6161
Mailing Address - Street 1:7301A W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 305A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3409
Mailing Address - Country:US
Mailing Address - Phone:561-393-6161
Mailing Address - Fax:561-393-5331
Practice Address - Street 1:7301A W PALMETTO PARK RD
Practice Address - Street 2:SUITE 305A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3409
Practice Address - Country:US
Practice Address - Phone:561-393-6161
Practice Address - Fax:561-393-5331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY981231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AY981OtherSTATE OF FLORIDA DEPT OF HEALTH