Organization
REALEAR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CROGAN (OWNER)
(386) 761-5780
Entity
Organization
Contact information
Practice address
790 DUNLAWTON AVE, SUITE B, PORT ORANGE, FL 32127-9279
(386) 761-5780
Mailing address
790 DUNLAWTON AVENUE, SUITE B, PORT ORANGE, FL 32127
(386) 761-5780
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
00016100
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J8157
BLUE CROSS AND BLUE SHIELD
FL
Enumeration date
05/05/2008
Last updated
03/04/2009
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