Blue Wave Psychiatry Llc | |
6601 Memorial Hwy Tampa FL 33615-4501 | |
(727) 871-1178 | |
Not Available |
Full Name | Blue Wave Psychiatry Llc |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 6601 Memorial Hwy, Tampa, Florida |
Authorized Official Name and Position | Felix Widlacki (CEO) |
Authorized Official Contact | 7278711178 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Blue Wave Psychiatry Llc 6601 Memorial Hwy Tampa FL 33615-4501 Ph: () - | Blue Wave Psychiatry Llc 6601 Memorial Hwy Tampa FL 33615-4501 Ph: (727) 871-1178 |
NPI Number | 1164857876 |
---|---|
Provider Enumeration Date | 09/12/2013 |
Last Update Date | 09/01/2020 |
Certification Date | 09/01/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164857876 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | OS11223 (Florida) | Primary |
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