Provider Demographics
NPI:1275852634
Name:THRONEBURG, JASON JAMES (HIS)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:JAMES
Last Name:THRONEBURG
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 HIGHWAY 44 W
Mailing Address - Street 2:SUITE #5
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34453-3873
Mailing Address - Country:US
Mailing Address - Phone:352-860-1100
Mailing Address - Fax:352-860-1109
Practice Address - Street 1:2240 HIGHWAY 44 W
Practice Address - Street 2:SUITE 5
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3873
Practice Address - Country:US
Practice Address - Phone:352-860-1100
Practice Address - Fax:352-860-1109
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS3622237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist