Provider Demographics
NPI:1912302738
Name:TRI-COUNTY HEARING AND SPEECH CENTERS, LLC
Entity Type:Organization
Organization Name:TRI-COUNTY HEARING AND SPEECH CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ-ROQUE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:561-320-9152
Mailing Address - Street 1:825 S US HIGHWAY 1
Mailing Address - Street 2:SUITE #100
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5976
Mailing Address - Country:US
Mailing Address - Phone:561-320-9152
Mailing Address - Fax:561-320-9153
Practice Address - Street 1:825 S US HIGHWAY 1
Practice Address - Street 2:SUITE #100
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5976
Practice Address - Country:US
Practice Address - Phone:561-320-9152
Practice Address - Fax:561-320-9153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY131237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLII786AMedicare PIN