Provider Demographics
NPI:1760609705
Name:INNOVATIVE AUDIOLOGY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:INNOVATIVE AUDIOLOGY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:SOMMERFLED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-562-8306
Mailing Address - Street 1:290 OLD DIXIE HIGWAY
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962
Mailing Address - Country:US
Mailing Address - Phone:772-562-8306
Mailing Address - Fax:772-562-8127
Practice Address - Street 1:8725 W HIGGINS RD
Practice Address - Street 2:SUITE 485
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2716
Practice Address - Country:US
Practice Address - Phone:800-537-4871
Practice Address - Fax:772-562-8127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Not Answered332S00000XSuppliersHearing Aid Equipment