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General NPI Number Information
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NPI Number | 1861172207
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Entity Type | Organization
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Legal Business Name | HYPERBARIC HAVEN
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 12794 FOREST HILL BLVD STE 9-10
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City | WELLINGTON
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State | FL
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Zip | 33414-4710
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Country | US
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Telephone | 954-592-4961
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Fax |
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Provider Business Mailing Address
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Address Line | 12794 FOREST HILL BLVD STE 9-10
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City | WELLINGTON
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State | FL
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Zip | 33414-4710
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Country | US
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Telephone | 954-592-4961
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY MCCALLA
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Credential |
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Telephone | 954-592-4961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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