Provider Demographics
NPI:1447587704
Name:BELTONE NORTHERN FLORIDA
Entity Type:Organization
Organization Name:BELTONE NORTHERN FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-921-3320
Mailing Address - Street 1:931 JEFFERSON BLVD STE 2001
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2245
Mailing Address - Country:US
Mailing Address - Phone:401-921-3320
Mailing Address - Fax:401-921-3327
Practice Address - Street 1:1013 A1A BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-6724
Practice Address - Country:US
Practice Address - Phone:904-460-0931
Practice Address - Fax:904-460-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL09000084556237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty