Provider Demographics
NPI:1447647011
Name:ADVANCED QUALITY HEARING SYSTEMS
Entity type:Organization
Organization Name:ADVANCED QUALITY HEARING SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FREIA
Authorized Official - Suffix:
Authorized Official - Credentials:HAS
Authorized Official - Phone:954-975-5756
Mailing Address - Street 1:2900 W SAMPLE RD # 129
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3024
Mailing Address - Country:US
Mailing Address - Phone:954-975-5756
Mailing Address - Fax:
Practice Address - Street 1:2900 W SAMPLE RD # 129
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33073-3024
Practice Address - Country:US
Practice Address - Phone:954-975-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2708237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty