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General NPI Number Information
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NPI Number | 1679421523
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Entity Type | Organization
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Legal Business Name | BLUE DOLPHIN MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 8491 S US HIGHWAY 1 STE 15
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-3360
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Country | US
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Telephone | 772-530-1346
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 SW CAMEO BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-2930
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEJANDRO DAVID VANDO PEDROSA
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Credential | MD
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Telephone | 772-530-1346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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