Provider Demographics
NPI:1497755003
Name:AUDIOLOGY HEARING AID CENTER OF SOUTH BROWARD, INC.
Entity Type:Organization
Organization Name:AUDIOLOGY HEARING AID CENTER OF SOUTH BROWARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:954-437-1766
Mailing Address - Street 1:306 S FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1722
Mailing Address - Country:US
Mailing Address - Phone:954-437-1766
Mailing Address - Fax:
Practice Address - Street 1:306 S FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1722
Practice Address - Country:US
Practice Address - Phone:954-437-1766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY327237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS0958ZMedicare ID - Type UnspecifiedINDIVIDUAL PROV. #
FLK1542Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER