Max Fullmer, BS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

AST1364 Issued in FL

Practice address

1077 Tamiami TRL N
Nokomis, FL 34275-2163

Phone

(941) 486-0950

NPI assigned

Sep 5, 2024

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifestyle Hearing Corporation USA Inc

  • Audiologist-Hearing Aid Fitter
  • Palm Beach Gardens, FL
  • NPI 1316338346

  Hearing Instrument Specialist

  NPD (past)
• Audiology Distribution, LLC

  • Audiologist-Hearing Aid Fitter
  • Dublin, OH
  • NPI 1164707998
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles (2 of 4)

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 5, 2024.

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1902631328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 PARKRIDGE CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342431447",
            "telephone_number": "757-288-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 TAMIAMI TRL N",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752163",
            "telephone_number": "941-486-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "MAX",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AST1364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Flynn, LCSW
• Angelo Fonte Jr., MD
• Monique Forbes-Dieujuste
• Katherine Anne Fratello
• Linda A Frease, MHS
• Maria Esther Galban
• Genesis Health Clinic & Services, Inc.
• Viktoria Gerzeny
• Autumn Gnutti
• Vicky L Golden, O.T./L

• All providers in Nokomis, FL
• Hearing Instrument Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.