| Organization Name: | CHESAPEAKE HYPERBARIC LC |
| NPI Number: | 1205159423 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE RENEE REILLO (DIRECTOR) |
| Mailing Address: | 129 Seagrove Main Street Unit 202 St. Augustine |
| State: | FL US |
| Postal Code: | 32080 |
| Phone Number: | 8042964094 |
| Fax Number: | |
| NPI Enumeration Date: | 03/02/2010 |
| NPI Last Update Date: | 03/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | R080304 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |