| Blue Dolphin Health Care, Corp. | |
|
777 E 25th St # 302 Hialeah FL 33013-3825 | |
| (786) 553-0954 | |
| (786) 502-2503 |
| Full Name | Blue Dolphin Health Care, Corp. |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 777 E 25th St, Hialeah, Florida |
| Authorized Official Name and Position | Asuncion Marina Munoz (ADULT PSYCHIATRY-NP /OWNER) |
| Authorized Official Contact | 7865530954 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Dolphin Health Care, Corp. 777 E 25th St # 302 Hialeah FL 33013-3825 Ph: (786) 553-0954 | Blue Dolphin Health Care, Corp. 777 E 25th St # 302 Hialeah FL 33013-3825 Ph: (786) 553-0954 |
| NPI Number | 1477990869 |
|---|---|
| Provider Enumeration Date | 05/27/2013 |
| Last Update Date | 05/27/2013 |
| Medicare PECOS PAC ID | 8729227780 |
|---|---|
| Medicare Enrollment ID | O20130624000257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477990869 | NPI | - | NPPES |
| EL117A | Other | FL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 8287 (Florida) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 9292609 (Florida) | Primary |
| Provider Name | Asuncion M. Munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376736363 PECOS PAC ID: 2769662758 Enrollment ID: I20110208000883 |
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