Provider Demographics
NPI:1811010762
Name:KIEFER PROFESSIONAL SERVICES INC.
Entity Type:Organization
Organization Name:KIEFER PROFESSIONAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JULES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:KIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:239-262-5800
Mailing Address - Street 1:848 1ST AVE N
Mailing Address - Street 2:SUITE 340
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6013
Mailing Address - Country:US
Mailing Address - Phone:239-262-5800
Mailing Address - Fax:239-262-0614
Practice Address - Street 1:848 1ST AVE N
Practice Address - Street 2:SUITE 340
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6013
Practice Address - Country:US
Practice Address - Phone:239-262-5800
Practice Address - Fax:239-262-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY570231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS-1338AMedicare ID - Type UnspecifiedAUDIOLOGIST