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
Update your record
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