Provider Demographics
NPI:1255636098
Name:ADVANCED HEARING GROUP, LLC
Entity type:Organization
Organization Name:ADVANCED HEARING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHMALENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-873-1722
Mailing Address - Street 1:PO BOX 350086
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32735-0086
Mailing Address - Country:US
Mailing Address - Phone:352-873-1722
Mailing Address - Fax:352-873-1622
Practice Address - Street 1:8602 SW HIGHWAY 200 STE E
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7808
Practice Address - Country:US
Practice Address - Phone:352-873-1722
Practice Address - Fax:352-873-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty