Audiology Consultants PA of Panama City
Organization Active NPI Audiologist · Lynn Haven, FL
NPI 1306068523 · NPPES record last updated May 8, 2018
Key facts
- NPI
- 1306068523
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Audiologist 231H00000X
- License
- AY1111 (FL)
- Legal business name
- AUDIOLOGY CONSULTANTS PA OF PANAMA CITY
- Practice address
- 2518 S Highway 77 Ste a
Lynn Haven, FL 32444-4730 - Phone
- (850) 769-2705
- Fax
- (850) 769-1097
- NPI assigned
- May 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Marcus P Kolmetz, AUD CCCA
- Title
- Owner and Audiologist
- Phone
- (850) 769-2705
Practitioners 2
-
Marcus P Kolmetz, MA CCCA
-
Christina M Deegins, HIS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070813000440 | FL | Part B Supplier - Clinic/Group Practice | 4183715642 |
Receives reassigned benefits from 1 practitioner Practice locations: Lynn Haven, FL |
National Provider Directory
Locations
2518 S Highway 77
Ste A
Lynn Haven, FL 32444
Phone (850) 653-2935
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist |
231H00000X | AY370 | FL | |
| Audiologist |
231H00000X | AY1111 | FL | Yes |
Addresses
Primary practice location
2518 S Highway 77 Ste a
Lynn Haven, FL 32444-4730
Mailing address
2518 S Highway 77 Ste a
Lynn Haven, FL 32444-4730
Phone (850) 769-2705
Other providers in Lynn Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.