Bluewater Orthopedics, PA

Organization Active NPI Sports Medicine (Internal Medicine) Physician · Niceville, FL

NPI 1780628255 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1780628255
Entity type
Organization (NPI type 2)
Primary specialty
Sports Medicine (Internal Medicine) Physician 207RS0010X
License
ME0060265 (FL)
Legal business name
BLUEWATER ORTHOPEDICS, PA
Practice address
1950 Bluewater Blvd
Suite 100
Niceville, FL 32578-3887
Phone
(850) 897-8081
Fax
(850) 897-1520
NPI assigned
Jun 15, 2006
Organization subpart
No

Authorized official

Name
Linda Ann Strickland
Title
Practice Administrator
Phone
(850) 897-8081

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Bluewater Orthopedics PA (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RS0010X ME0060265 FL Yes

Addresses

Primary practice location

1950 Bluewater Blvd
Suite 100
Niceville, FL 32578-3887

Mailing address

1950 Bluewater Blvd
Suite 100
Niceville, FL 32578-3887
Phone (850) 897-8081

Other identifiers

IdentifierTypeStateIssuer
14883BOtherFLBCBSFL

Other providers in Niceville, FL

All providers in Niceville, FL · Sports Medicine (Internal Medicine) Physician in Florida

Sources for this page

Verify at the official NPI Registry.