Healthcare Provider Details

I. General information

NPI: 1730008657
Provider Name (Legal Business Name): BLUCOVE PSYCHIATRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 METRO PKWY STE 200
FORT MYERS FL
33916-9408
US

IV. Provider business mailing address

4415 METRO PKWY STE 200
FORT MYERS FL
33916-9408
US

V. Phone/Fax

Practice location:
  • Phone: 786-210-2600
  • Fax:
Mailing address:
  • Phone: 786-210-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SANDRA PELAEZ-MUNSEY
Title or Position: OWNER
Credential: DNP
Phone: 786-210-2600