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General NPI Number Information
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NPI Number | 1588059315
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Entity Type | Organization
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Legal Business Name | OCEAN BLUE MEDICAL INC
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 6018 SW 8 ST SUITE 2
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 786-678-0623
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Fax | 801-697-0935
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Provider Business Mailing Address
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Address Line | 6018 SW 8 ST SUITE 2
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 786-678-0623
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Fax | 801-697-0935
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Authorized Official
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Title or Position | OWNER
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Name | PEDRO C PEREZ
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Credential |
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Telephone | 786-678-0623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | FL
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