Provider Demographics
NPI:1851392849
Name:AMERICAN INSTITUTE OF BALANCE INC
Entity Type:Organization
Organization Name:AMERICAN INSTITUTE OF BALANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:GANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-398-5728
Mailing Address - Street 1:8200 BRYAN DAIRY RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1363
Mailing Address - Country:US
Mailing Address - Phone:727-398-5728
Mailing Address - Fax:727-398-4914
Practice Address - Street 1:8200 BRYAN DAIRY RD
Practice Address - Street 2:SUITE 340
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1363
Practice Address - Country:US
Practice Address - Phone:727-398-5728
Practice Address - Fax:727-398-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV1715OtherBCBS FL
FLV1715OtherBCBS FL