Provider Demographics
NPI:1902051055
Name:ALVAREZ AUDIOLOGY & HEARING
Entity Type:Organization
Organization Name:ALVAREZ AUDIOLOGY & HEARING
Other - Org Name:PALM COAST HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:386-283-4932
Mailing Address - Street 1:160 CYPRESS POINT PKWY STE A108
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-8438
Mailing Address - Country:US
Mailing Address - Phone:386-283-4932
Mailing Address - Fax:862-834-9343
Practice Address - Street 1:115 E GRANADA BLVD STE 7
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176-6634
Practice Address - Country:US
Practice Address - Phone:386-492-2923
Practice Address - Fax:386-283-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1479231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBN371AMedicare UPIN