Provider Demographics
NPI:1689813271
Name:ABJ INC
Entity Type:Organization
Organization Name:ABJ INC
Other - Org Name:ST JOHNS HEARING INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:727-791-4090
Mailing Address - Street 1:2725 PARK DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1023
Mailing Address - Country:US
Mailing Address - Phone:727-791-4090
Mailing Address - Fax:727-791-4220
Practice Address - Street 1:2725 PARK DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1023
Practice Address - Country:US
Practice Address - Phone:727-791-4090
Practice Address - Fax:727-791-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2019237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty