Provider Demographics
NPI:1124129408
Name:HYPERBARIC SERVICES OF THE PALM BEACHES LLC
Entity type:Organization
Organization Name:HYPERBARIC SERVICES OF THE PALM BEACHES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GOVERNALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-819-6125
Mailing Address - Street 1:SUITE H 3&4
Mailing Address - Street 2:5130 LINTON BLVD, PALM COURT PLAZA
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6597
Mailing Address - Country:US
Mailing Address - Phone:561-818-6125
Mailing Address - Fax:561-819-6127
Practice Address - Street 1:SUITE 3&4
Practice Address - Street 2:5130 LINTON BLVD PALM COURT PLAZA
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6597
Practice Address - Country:US
Practice Address - Phone:561-818-6125
Practice Address - Fax:561-819-6127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL98328OtherBLUE CORSS/BLUE SHEILD
FLAF 168Medicare PIN
FL50888WMedicare UPIN