Provider Demographics
NPI:1922370485
Name:BAYSIDE HEARING AID CENTER INC
Entity Type:Organization
Organization Name:BAYSIDE HEARING AID CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:R
Authorized Official - Last Name:WINN
Authorized Official - Suffix:
Authorized Official - Credentials:AS BCHIS ACA
Authorized Official - Phone:239-415-0727
Mailing Address - Street 1:16450 SAN CARLOS BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3271
Mailing Address - Country:US
Mailing Address - Phone:239-415-0727
Mailing Address - Fax:239-288-4915
Practice Address - Street 1:16450 SAN CARLOS BLVD STE 3
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3271
Practice Address - Country:US
Practice Address - Phone:239-415-0727
Practice Address - Fax:239-288-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2687332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment