Provider Demographics
NPI:1700363736
Name:TWO RIVERS HEARING
Entity Type:Organization
Organization Name:TWO RIVERS HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:321-693-6474
Mailing Address - Street 1:627 LOGGERHEAD ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3849
Mailing Address - Country:US
Mailing Address - Phone:321-693-6474
Mailing Address - Fax:
Practice Address - Street 1:21 SUNTREE PL
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7600
Practice Address - Country:US
Practice Address - Phone:321-254-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1268231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty