Organization
CHARLOTTE HEARING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY LEE WALDEN AU.D. (OWNER)
(941) 766-8886
Entity
Organization
Contact information
Practice address
21216 OLEAN BLVD, SUITE 4, PORT CHARLOTTE, FL 33952-6722
(941) 766-8886
(941) 766-8804
Mailing address
21216 OLEAN BLVD, SUITE 4, PORT CHARLOTTE, FL 33952-6722
(941) 766-8886
(941) 766-8804
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY211
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ2976
R.R. MEDICARE
FL
01
—
J0825
BLUE CROSS/BLUE SHIELD
FL
01
—
T0849
BLUECROSS/BLUE SHIELD
FL
Enumeration date
10/05/2006
Last updated
08/22/2020
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