<Unavail>

LBN: 2096 East Ocean Boulevard, Lc
<Unavail> is an health care organization with primary practice located at 2096 Se Ocean Blvd , Stuart FL 34996-3304. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. 2096 East Ocean Boulevard, Lc can be contacted via phone (772) 223-0174, or through Tidwell, Barbara Ann via phone (772) 223-0174.

Contact Information

Primary practice address
2096 Se Ocean Blvd Stuart FL 34996-3304
Phone: (772) 223-0174
Fax: (772) 223-0558
Website:
Map and Directions
Authorized official contact:
Name: Tidwell, Barbara Ann
Phone: (772) 223-0174

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 901 Florida

Profile Details

NPI number 1609940899
LBN Legal business name 2096 East Ocean Boulevard, Lc
DBA Doing business as <Unavail>
Authorized official Tidwell, Barbara Ann
Entity Organization
Organization subpart 1 No
Enumeration date Nov 20th, 2006
Last updated Feb 2nd, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609940899 NPPES
Florida Other 0097410006 CIGNA
Florida MEDICAID 079144000 CIGNA
Florida Other 490004057 CIGNA
Florida Other 61D CIGNA

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