Provider Demographics
NPI:1275011389
Name:METAMPA, LLC
Entity Type:Organization
Organization Name:METAMPA, LLC
Other - Org Name:MIRACLE EAR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-230-4149
Mailing Address - Street 1:8300 CENTRAL PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6666
Mailing Address - Country:US
Mailing Address - Phone:254-227-5189
Mailing Address - Fax:
Practice Address - Street 1:7110 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-3216
Practice Address - Country:US
Practice Address - Phone:863-324-2288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty