Healthcare Provider Details

I. General information

NPI: 1548598550
Provider Name (Legal Business Name): BLUE SAIL MEDIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2009
Last Update Date: 12/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6316 W MACLAURIN DR
TAMPA FL
33647-1162
US

IV. Provider business mailing address

6316 W MACLAURIN DR
TAMPA FL
33647-1162
US

V. Phone/Fax

Practice location:
  • Phone: 813-443-4800
  • Fax: 813-866-3320
Mailing address:
  • Phone: 813-443-4800
  • Fax: 813-866-3320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number231346
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number231346
License Number StateFL

VIII. Authorized Official

Name: MRS. STEFFENIE K MURNANE
Title or Position: TREASURER
Credential:
Phone: 813-443-4800