Healthcare Provider Details

I. General information

NPI: 1669074928
Provider Name (Legal Business Name): AALTO HYPERBARIC OXYGEN MARGATE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 N STATE ROAD 7 SUITE AB
MARGATE FL
33063
US

IV. Provider business mailing address

2080 CENTURY PARK EAST SUITE 200
LOS ANGELES CA
90067
US

V. Phone/Fax

Practice location:
  • Phone: 954-975-3563
  • Fax: 954-975-0338
Mailing address:
  • Phone: 310-507-7942
  • Fax: 310-507-7943

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
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SHIRLEE JACKSON
Title or Position: CHIEF OPERATIONS OFFICE
Credential:
Phone: 310-507-7946