Healthcare Provider Details

I. General information

NPI: 1831302942
Provider Name (Legal Business Name): HYPERBARIC ASSOCIATES OF FLORIDA P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SHERIDAN ST
PEMBROKE PINES FL
33024-2536
US

IV. Provider business mailing address

PO BOX 245835
PEMBROKE PINES FL
33024-0113
US

V. Phone/Fax

Practice location:
  • Phone: 954-963-8014
  • Fax:
Mailing address:
  • Phone: 954-384-9997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. BLANE SHATKIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-384-9997