MEDICARE: WESTON HYPERBARIC THERAPY LLC

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	261QR0800X	Recovery Care Clinic/Center
2	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1265252142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTON HYPERBARIC THERAPY LLC

Provider Business Mailing Address
First Line	:	2731 EXECUTIVE PARK DR STE 4
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3619
Country	:	US
Telephone Number	:	954-444-6577
Fax Number	:

Provider Business Practice Location Address
First Line	:	2731 EXECUTIVE PARK DR STE 4
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3619
Country	:	US
Telephone Number	:	954-444-6577
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHELLE LYN SUAREZ
Credential	:
Telephone Number	:	954-444-6577

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	10/29/2024

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