Provider Demographics
NPI:1275846719
Name:HEALTHY HEARING & BALANCE CLINIC
Entity Type:Organization
Organization Name:HEALTHY HEARING & BALANCE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER/PHYSICAIN
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:863-647-5700
Mailing Address - Street 1:5424 STRICKLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812
Mailing Address - Country:US
Mailing Address - Phone:863-647-5700
Mailing Address - Fax:863-647-5700
Practice Address - Street 1:5424 STRICKLAND AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4264
Practice Address - Country:US
Practice Address - Phone:863-647-5700
Practice Address - Fax:863-647-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAV1203174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600453900Medicaid