MEDICARE: HYPERBARIC OXYGEN SPECIALIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	ME10390	FL

General Provider Information

NPI Number	:	1194773812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYPERBARIC OXYGEN SPECIALIST

Provider Business Mailing Address
First Line	:	PO BOX 919049
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-9049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 UNIVERSITY BLVD S
Second Line	:	SUITE 221
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4377
Country	:	US
Telephone Number	:	904-391-1206
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FREDERICK K VONTZ
Credential	:	MD
Telephone Number	:	904-399-1206

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/22/2020

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Directions to “HYPERBARIC OXYGEN SPECIALIST ” Practice Location

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