Provider Demographics
NPI:1104221746
Name:LOVE, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LOVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 VILLAGE BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1934
Mailing Address - Country:US
Mailing Address - Phone:561-683-2399
Mailing Address - Fax:
Practice Address - Street 1:771 VILLAGE BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1934
Practice Address - Country:US
Practice Address - Phone:561-683-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4907237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist