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General NPI Number Information
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NPI Number | 1235512138
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Entity Type | Organization
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Legal Business Name | BLUE HORIZON MEDICAL CLINIC L.L.C.
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 5101 E BUSCH BLVD STE 11
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City | TAMPA
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State | FL
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Zip | 33617-5380
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Country | US
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Telephone | 813-899-9797
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Fax | 813-433-5553
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Provider Business Mailing Address
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Address Line | 30701 WRENCREST DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-7845
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Country | US
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Telephone | 813-899-9797
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Fax |
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Authorized Official
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Title or Position | CEO, OWNER
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Name | MRS. SHARON DENISE BLUE
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Credential | DNP, APRN, ANP-C
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Telephone | 813-899-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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