Provider Demographics
NPI:1497205736
Name:HEARING EDUCATION ASSESMENT AND REHABILITATION MOBILE SERVICES
Entity Type:Organization
Organization Name:HEARING EDUCATION ASSESMENT AND REHABILITATION MOBILE SERVICES
Other - Org Name:HEAR MOBILE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKINNON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:772-696-4327
Mailing Address - Street 1:615 SE HIBISCUS AVE
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3602
Mailing Address - Country:US
Mailing Address - Phone:772-696-4327
Mailing Address - Fax:
Practice Address - Street 1:615 SE HIBISCUS AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3602
Practice Address - Country:US
Practice Address - Phone:772-696-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty