Provider Demographics
NPI:1851306211
Name:TRINITY HEARING &BALANCE CENTER
Entity Type:Organization
Organization Name:TRINITY HEARING &BALANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:727-372-1130
Mailing Address - Street 1:70 DEERPATH CT
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2054
Mailing Address - Country:US
Mailing Address - Phone:727-871-1753
Mailing Address - Fax:
Practice Address - Street 1:3633 LITTLE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1815
Practice Address - Country:US
Practice Address - Phone:727-372-1130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY296231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty