Healthcare Provider Details

I. General information

NPI: 1114895349
Provider Name (Legal Business Name): HYDRATE FLOW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 561-462-1808
  • Fax: 561-462-1808
Mailing address:
  • Phone: 561-462-1808
  • Fax: 561-462-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: ANN-ISABELLE DE LORETTA
Title or Position: MANAGER
Credential: NP
Phone: 561-462-1808