| Blue Water Health And Wellness Llc | |
|
340 Town Place Ave. Suite 240 Ponte Vedra FL 32081 | |
| (904) 595-2583 | |
| (904) 595-2584 |
| Full Name | Blue Water Health And Wellness Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 340 Town Place Ave. Suite 240, Ponte Vedra, Florida |
| Authorized Official Name and Position | Edward P Secunda (PRESIDENT) |
| Authorized Official Contact | 9045952583 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Water Health And Wellness Llc 340 Town Place Ave. Suite 240 Ponte Vedra FL 32081 Ph: (904) 595-2583 | Blue Water Health And Wellness Llc 340 Town Place Ave. Suite 240 Ponte Vedra FL 32081 Ph: (904) 595-2583 |
| NPI Number | 1396379780 |
|---|---|
| Provider Enumeration Date | 02/25/2020 |
| Last Update Date | 02/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396379780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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