Organization
HYPERBARIC TREATMENT ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE RENEE REILLO PHD (DIRECTOR)
(804) 296-4094
Entity
Organization
Contact information
Practice address
129 SEAGROVE MAIN STREET, 202, SAINT AUGUSTINE, FL 32080-6376
(804) 296-4094
Mailing address
129 SEAGROVE MAIN STREET, 202, SAINT AUGUSTINE, FL 32080
(804) 296-4094
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
RN9303002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407050024
JOHN DELUCA, M.D., MEDICAL DIRECTOR, NPI
FL
Enumeration date
10/07/2010
Last updated
09/21/2012
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