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General NPI Number Information
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NPI Number | 1700723285
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Entity Type | Organization
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Legal Business Name | HYDROPOLIS LOUNGE LLC
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 1054 GATEWAY BLVD STE 108
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8309
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Country | US
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Telephone | 561-791-6241
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Fax | 561-335-3364
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Provider Business Mailing Address
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Address Line | 1054 GATEWAY BLVD STE 108
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8309
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Country | US
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Telephone | 561-791-6241
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Fax | 561-335-3364
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDRA TAYLOR BLAKELY
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Credential | MD
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Telephone | 954-598-4215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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