Provider Demographics
NPI:1417008434
Name:AUDIOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:AUDIOLOGICAL SERVICES, INC.
Other - Org Name:THE HEARING SOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:813-643-1652
Mailing Address - Street 1:675 W LUMSDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5911
Mailing Address - Country:US
Mailing Address - Phone:813-643-1652
Mailing Address - Fax:813-643-1786
Practice Address - Street 1:675 W LUMSDEN RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5911
Practice Address - Country:US
Practice Address - Phone:813-643-1652
Practice Address - Fax:813-643-1786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY979231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6556665OtherCIGNA NUMBER
FL7640640OtherAETNA NUMBER
FLS2353OtherBCBS OF FL NUMBER
FL600266800Medicaid
FLS2353OtherBCBS OF FL NUMBER
FL6556665OtherCIGNA NUMBER