Provider Demographics
NPI:1326568122
Name:PITRE, EDUARDO (HAS)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:PITRE
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 W GRANADA BLVD STE 46
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-9406
Mailing Address - Country:US
Mailing Address - Phone:386-872-5252
Mailing Address - Fax:
Practice Address - Street 1:725 W GRANADA BLVD STE 46
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9406
Practice Address - Country:US
Practice Address - Phone:386-872-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist