Provider Demographics
NPI:1184016875
Name:MID FLORIDA HEARING, LLC
Entity Type:Organization
Organization Name:MID FLORIDA HEARING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ELLER
Authorized Official - Suffix:
Authorized Official - Credentials:HAS, BC-HIS
Authorized Official - Phone:352-360-0023
Mailing Address - Street 1:10601 US HIGHWAY 441
Mailing Address - Street 2:UNIT E-1
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-7237
Mailing Address - Country:US
Mailing Address - Phone:352-360-0023
Mailing Address - Fax:352-360-0013
Practice Address - Street 1:10601 US HIGHWAY 441
Practice Address - Street 2:UNIT E-1
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-7237
Practice Address - Country:US
Practice Address - Phone:352-360-0023
Practice Address - Fax:352-360-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2734332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment