Provider Demographics
NPI:1184093262
Name:ATLANTIC AUDIOLOGY, LLC
Entity type:Organization
Organization Name:ATLANTIC AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEASELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-584-9586
Mailing Address - Street 1:1680 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4754
Mailing Address - Country:US
Mailing Address - Phone:386-756-8225
Mailing Address - Fax:386-767-0742
Practice Address - Street 1:1680 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4754
Practice Address - Country:US
Practice Address - Phone:386-756-8225
Practice Address - Fax:386-767-0742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty