MEDICARE: BLUE WAVE MEDICAL ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1760167233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE WAVE MEDICAL ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	1105 S FORT HARRISON AVE
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3907
Country	:	US
Telephone Number	:	727-303-3117
Fax Number	:	727-335-4430

Provider Business Practice Location Address
First Line	:	1822 DREW ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33765-2921
Country	:	US
Telephone Number	:	917-576-7624
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AUDREY Z PAUL
Credential	:	MD
Telephone Number	:	917-576-7624

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	12/11/2025

Similar Medicare Providers

1326817487 — JONATHAN WILLIAM HODSON DC
Practice Location Address:

1822 DREW ST STE 108
CLEARWATER, FL
33765-2921

Practice Phone: 765-318-9797
Practice Fax:

1952165573 — JIREH CHIROPRACTIC LLC
Practice Location Address:

1822 DREW ST
CLEARWATER, FL
33765-2921

Practice Phone: 765-318-9797
Practice Fax:

1427948579 — MONICA MORA
Practice Location Address:

1822 DREW ST STE 105
CLEARWATER, FL
33765-2921

Practice Phone: 425-503-6125
Practice Fax:

1679578470 — AVEE, INC.
Practice Location Address:

407 N BELCHER RD
CLEARWATER, FL
33765-2607

Practice Phone: 727-450-0700
Practice Fax: 727-450-0710

1346245891 — ELIAS M. KOLETTIS D.O.
Practice Location Address:

701 N HERCULES AVE , STE B
CLEARWATER, FL
33765-2029

Practice Phone: 727-738-8410
Practice Fax: 727-734-6254

1720084445 — DR. BARRY M. RODWICK M. D.
Practice Location Address:

2349 SUNSET POINT RD , SUITE 405
CLEARWATER, FL
33765-1456

Practice Phone: 727-216-6193
Practice Fax: 727-216-4992

Directions to “BLUE WAVE MEDICAL ASSOCIATES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.