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General NPI Number Information
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NPI Number | 1689041568
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Entity Type | Organization
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Legal Business Name | HYDR8
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 1539 2ND ST
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City | SARASOTA
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State | FL
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Zip | 34236-8503
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Country | US
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Telephone | 866-223-8707
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Fax | 888-763-2704
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Provider Business Mailing Address
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Address Line | 1539 2ND ST
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City | SARASOTA
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State | FL
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Zip | 34236-8503
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Country | US
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Telephone | 866-223-8707
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Fax | 888-763-2704
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Authorized Official
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Title or Position | CEO
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Name | FERNANDO A VEGA
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Credential |
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Telephone | 866-223-8707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State | FL
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