Organization
LAKELAND PROFESSIONAL HEARING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA L SHOWALTER M.S. (AUDIOLOGIST/CEO)
(863) 859-0754
Entity
Organization
Contact information
Practice address
5353 N SOCRUM LOOP RD, LAKELAND, FL 33809-4256
(863) 859-0754
(863) 859-4630
Mailing address
5353 N SOCRUM LOOP RD, LAKELAND, FL 33809-4256
(863) 859-0754
(863) 859-4630
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S2917
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/21/2007
Last updated
11/21/2007
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