Healthcare Provider Details

I. General information

NPI: 1124129408
Provider Name (Legal Business Name): HYPERBARIC SERVICES OF THE PALM BEACHES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUITE 3&4 5130 LINTON BLVD PALM COURT PLAZA
DELRAY BEACH FL
33484-6597
US

IV. Provider business mailing address

SUITE H 3&4 5130 LINTON BLVD, PALM COURT PLAZA
DELRAY BEACH FL
33484-6597
US

V. Phone/Fax

Practice location:
  • Phone: 561-818-6125
  • Fax: 561-819-6127
Mailing address:
  • Phone: 561-818-6125
  • Fax: 561-819-6127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS CONSTANCE ANNE GOVERNALE
Title or Position: ADMINISTRATOR
Credential:
Phone: 561-819-6125