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General NPI Number Information
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NPI Number | 1881923118
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Entity Type | Organization
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Legal Business Name | NAUTILUS HEALTH CARE GROUP LLC
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 211 E 7TH ST STE 620
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City | AUSTIN
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State | TX
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Zip | 78701-3218
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Country | US
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Telephone | 727-867-5480
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Fax | 727-867-5470
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Provider Business Mailing Address
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Address Line | PO BOX 530968
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City | ST PETERSBURG
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State | FL
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Zip | 33747-0968
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Country | US
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Telephone | 727-823-2188
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Fax | 727-828-0723
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Authorized Official
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Title or Position | CEO
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Name | FRANK WILLIAMS
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Credential |
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Telephone | 904-446-3519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | N3910
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | N3910
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License Number State | TX
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Taxonomy #3
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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 | N3910
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License Number State | TX
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