FLORIDA BLUE STAR INC NPI 1053993550

NPI Information

NPI: 1053993550
Provider Name: FLORIDA BLUE STAR INC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D2247199

Address:
1325 SE 47TH ST STE I
CAPE CORAL, FL
ZIP 33904
Phone: (239) 205-2337
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FLORIDA BLUE STAR INC is a primary care nurse practitioner in Cape Coral, FL. FLORIDA BLUE STAR INC NPI is 1053993550. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1325 SE 47TH ST STE I
CAPE CORAL, FL
ZIP 33904-669
Phone: (239) 205-2337
Fax: (239) 310-5287

The provider's authorized official is Yudith Simon .
The authorized official title is Advanced Practice Registered Nurse and has the following contact phone number (305) 803-4502.

The CLIA number assigned to this NPI record is 10D2247199 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2021 and was last updated on 4/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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