Provider Demographics
NPI:1750504718
Name:FIRST COAST HEARING CLINIC, INC.
Entity Type:Organization
Organization Name:FIRST COAST HEARING CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-447-7364
Mailing Address - Street 1:50 CYPRESS POINT PKWY
Mailing Address - Street 2:SUITE B3
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-2500
Mailing Address - Country:US
Mailing Address - Phone:386-447-7364
Mailing Address - Fax:386-447-8742
Practice Address - Street 1:50 CYPRESS POINT PKWY
Practice Address - Street 2:SUITE B3
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2500
Practice Address - Country:US
Practice Address - Phone:386-447-7364
Practice Address - Fax:386-447-8742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY689231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty