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General NPI Number Information
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NPI Number | 1083060560
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Entity Type | Organization
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Legal Business Name | HYPERBARIC CENTERS OF SOUTHWEST FLORIDA, LLC
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 09/12/2016
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Provider Practice Location Address
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Address Line | 4458 BEE RIDGE RD UNIT # 18
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City | SARASOTA
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State | FL
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Zip | 34233-2502
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Country | US
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Telephone | 941-726-5331
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Fax |
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Provider Business Mailing Address
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Address Line | 4458 BEE RIDGE RD UNIT # 18
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City | SARASOTA
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State | FL
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Zip | 34233-2502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. BOB CREDEROTH
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Credential |
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Telephone | 941-726-5331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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