1518518042 NPI number — HYPERBARIC HEALTH SERVICES - PALATKA LLC

Table of content: GABRIELLE CYNTHIA DAVIS CRNA (NPI 1750797742)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518518042 NPI number — HYPERBARIC HEALTH SERVICES - PALATKA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HYPERBARIC HEALTH SERVICES - PALATKA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518518042
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
608 POINSETTIA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST AUGUSTINE BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32080-6849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-540-8797
Provider Business Mailing Address Fax Number:
904-797-2852

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
524 ZEAGLER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALATKA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32177-3813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-385-3857
Provider Business Practice Location Address Fax Number:
904-530-2052
Provider Enumeration Date:
09/25/2019

Additional Information

Authorized Official

Authorized Official Last Name:
HALL
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
MITCHELL
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
386-385-3857

Provider Taxonomy Codes

  • Taxonomy code: 207PE0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083P0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com