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General NPI Number Information
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NPI Number | 1508725912
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Entity Type | Organization
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Legal Business Name | ROCKLEDGE HBOT LLC
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 1257 FLORIDA AVE S STE A&B
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2435
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Country | US
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Telephone | 321-926-6278
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Fax | 321-926-6278
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 321-400-8736
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Fax | 321-926-6278
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Authorized Official
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Title or Position | CEO
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Name | MR. JOANELL PARIS-SANTOS
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Credential |
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Telephone | 407-388-4980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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