Provider Demographics
NPI:1952471732
Name:AUDIOLOGY ASSOCIATES OF SOUTH FLORIDA INC.
Entity Type:Organization
Organization Name:AUDIOLOGY ASSOCIATES OF SOUTH FLORIDA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:954-752-1559
Mailing Address - Street 1:5411 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4637
Mailing Address - Country:US
Mailing Address - Phone:954-752-1559
Mailing Address - Fax:954-752-1560
Practice Address - Street 1:5411 N UNIVERSITY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4637
Practice Address - Country:US
Practice Address - Phone:954-752-1559
Practice Address - Fax:954-752-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY24231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600530600Medicaid
S0874Medicare UPIN
FL600530600Medicaid
FLS0874Medicare UPIN