Provider Demographics
NPI:1821477316
Name:HEARING CENTER AT ENTA LLC
Entity Type:Organization
Organization Name:HEARING CENTER AT ENTA LLC
Other - Org Name:HELIX HEARING CARE FLORIDA PA MBR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT NAT. INS. ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:NAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLACHANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-821-6715
Mailing Address - Street 1:3190 N MCMULLEN BOOTH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2013
Mailing Address - Country:US
Mailing Address - Phone:727-791-1368
Mailing Address - Fax:
Practice Address - Street 1:3190 N MCMULLEN BOOTH RD STE 100
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2013
Practice Address - Country:US
Practice Address - Phone:727-791-1368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty