Provider Demographics
NPI:1467765248
Name:RIVERWALK HEARING CENTER
Entity Type:Organization
Organization Name:RIVERWALK HEARING CENTER
Other - Org Name:DANIEL P. TALARICO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:TALARICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-254-3347
Mailing Address - Street 1:PO BOX 372810
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-0810
Mailing Address - Country:US
Mailing Address - Phone:321-254-3347
Mailing Address - Fax:321-254-5461
Practice Address - Street 1:3134 LAKE WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-7616
Practice Address - Country:US
Practice Address - Phone:321-254-3347
Practice Address - Fax:321-254-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS1760332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment