Provider Demographics
NPI:1134705767
Name:PALM BEACH HEARING ASSOCIATES, PLLC
Entity type:Organization
Organization Name:PALM BEACH HEARING ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURARIY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:561-708-6247
Mailing Address - Street 1:2401 PGA BLVD STE 128
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3515
Mailing Address - Country:US
Mailing Address - Phone:561-500-3277
Mailing Address - Fax:
Practice Address - Street 1:420 S STATE ROAD 7 STE 122
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4304
Practice Address - Country:US
Practice Address - Phone:561-708-6247
Practice Address - Fax:561-567-0940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022661200Medicaid