# BEACHES EAR, NOSE AND THROAT, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013391275
- **Authorized official:** DR. JEFFREY E BRINK M.D. (OWNER)
- **Authorized official phone:** (904) 247-4070

## Contact information

- **Practice address:** 3200 3RD ST S, SUITE 101, JACKSONVILLE BEACH, FL 32250-6096
- **Practice address phone:** (904) 247-4070
- **Practice address fax:** (904) 247-4131
- **Mailing address:** PO BOX 3217, PONTE VEDRA BEACH, FL 32004-3217
- **Mailing address phone:** (904) 247-4070
- **Mailing address fax:** (904) 247-4131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231HA2400X | Assistive Technology Practitioner Audiologist | AY1951 | FL | Yes |

## Other

- **Enumeration date:** 07/16/2015
- **Last updated:** 07/16/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 269691601 | — | FL |