Provider Demographics
NPI:1225306475
Name:TAMJO INC
Entity Type:Organization
Organization Name:TAMJO INC
Other - Org Name:T & J NOBILE HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FONFARA
Authorized Official - Suffix:JR
Authorized Official - Credentials:HIS
Authorized Official - Phone:941-629-8808
Mailing Address - Street 1:2811 STE. A TAMIAMI TRAIL
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952
Mailing Address - Country:US
Mailing Address - Phone:941-629-8808
Mailing Address - Fax:941-629-1025
Practice Address - Street 1:2811 STE. A TAMIAMI TRAIL
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952
Practice Address - Country:US
Practice Address - Phone:941-629-8808
Practice Address - Fax:941-629-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS3621237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty