| Organization Name: | BEACHES EAR, NOSE AND THROAT, PA |
| NPI Number: | 1013391275 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY E BRINK (OWNER) |
| Mailing Address: | 3200 3rd St S Suite 101 Jacksonville Beach |
| State: | FL US |
| Postal Code: | 322506096 |
| Phone Number: | 9042474070 |
| Fax Number: | 9042474131 |
| NPI Enumeration Date: | 07/16/2015 |
| NPI Last Update Date: | 07/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 231HA2400X |
| License Number: | AY1951 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Audiologist |
| Taxonomy Specialization: | Assistive Technology Practitioner |
| Taxonomy Definition: | |