Provider Demographics
NPI:1659904944
Name:INFANT HEARING SERVICES LLC
Entity Type:Organization
Organization Name:INFANT HEARING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARBIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-246-1219
Mailing Address - Street 1:321 SE 3RD ST APT F18
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-1810
Mailing Address - Country:US
Mailing Address - Phone:352-246-1219
Mailing Address - Fax:
Practice Address - Street 1:321 SE 3RD ST APT F18
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-1810
Practice Address - Country:US
Practice Address - Phone:352-246-1219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-15
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency