Provider Demographics
NPI:1457377400
Name:ADVANCED HEARING TECHNOLOGY, INC.
Entity Type:Organization
Organization Name:ADVANCED HEARING TECHNOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:DUNNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:239-434-7000
Mailing Address - Street 1:5470 BRYSON CT STE 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-6000
Mailing Address - Country:US
Mailing Address - Phone:239-434-7000
Mailing Address - Fax:
Practice Address - Street 1:3350 WOODS EDGE CIR STE 101
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134
Practice Address - Country:US
Practice Address - Phone:239-948-3434
Practice Address - Fax:239-498-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL972860231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS1346AMedicare PIN