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Organization

BEACHES EAR, NOSE AND THROAT, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY E BRINK M.D. (OWNER)
(904) 247-4070
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
231HA2400X
Assistive Technology Practitioner Audiologist
Primary
AY1951
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269691601
FL
Enumeration date
07/16/2015
Last updated
07/16/2015
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