Provider Demographics
NPI:1407806508
Name:TAMPA BAY HEARING AND BALANCE CENTER
Entity Type:Organization
Organization Name:TAMPA BAY HEARING AND BALANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BARTELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-844-4900
Mailing Address - Street 1:5 TAMPA GENERAL CIRCLE
Mailing Address - Street 2:SUITE 610
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3589
Mailing Address - Country:US
Mailing Address - Phone:813-844-4900
Mailing Address - Fax:813-844-4905
Practice Address - Street 1:5 TAMPA GENERAL CIRCLE
Practice Address - Street 2:SUITE 610
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3589
Practice Address - Country:US
Practice Address - Phone:813-844-4900
Practice Address - Fax:813-844-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036442207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0124Medicare PIN