Provider Demographics
NPI:1356601967
Name:DESTIN HEARING SPECIALISTS, LLC
Entity type:Organization
Organization Name:DESTIN HEARING SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-654-3373
Mailing Address - Street 1:50 S HOLIDAY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-8606
Mailing Address - Country:US
Mailing Address - Phone:850-654-3373
Mailing Address - Fax:850-654-3369
Practice Address - Street 1:50 S HOLIDAY RD
Practice Address - Street 2:SUITE 400
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-8606
Practice Address - Country:US
Practice Address - Phone:850-654-3373
Practice Address - Fax:850-654-3369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL05000122403332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment