Healthcare Provider Details

I. General information

NPI: 1518518042
Provider Name (Legal Business Name): HYPERBARIC HEALTH SERVICES - PALATKA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 ZEAGLER DR
PALATKA FL
32177-3813
US

IV. Provider business mailing address

608 POINSETTIA ST
ST AUGUSTINE BEACH FL
32080-6849
US

V. Phone/Fax

Practice location:
  • Phone: 386-385-3857
  • Fax: 904-530-2052
Mailing address:
  • Phone: 904-540-8797
  • Fax: 904-797-2852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT MITCHELL HALL
Title or Position: CHIEF OPERATING OFFICER
Credential: CHS
Phone: 386-385-3857