Provider Demographics
NPI:1578008116
Name:HYPERBARIC HEALING TREATMENT CENTER LLC
Entity Type:Organization
Organization Name:HYPERBARIC HEALING TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT, CHT
Authorized Official - Phone:407-530-0710
Mailing Address - Street 1:7932 W SAND LAKE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7299
Mailing Address - Country:US
Mailing Address - Phone:407-530-0710
Mailing Address - Fax:407-530-0711
Practice Address - Street 1:7932 W SAND LAKE RD STE 103
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7299
Practice Address - Country:US
Practice Address - Phone:407-530-0710
Practice Address - Fax:407-530-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCCE607441261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center