Healthcare Provider Details

I. General information

NPI: 1508725912
Provider Name (Legal Business Name): ROCKLEDGE HBOT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 FLORIDA AVE S STE A&B
ROCKLEDGE FL
32955-2435
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 321-926-6278
  • Fax: 321-926-6278
Mailing address:
  • Phone: 321-400-8736
  • Fax: 321-926-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
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. JOANELL PARIS-SANTOS
Title or Position: CEO
Credential:
Phone: 321-676-3200