| Blue Seas Medical Llc | |
|
5850 Se Community Dr Stuart FL 34997-6420 | |
| (772) 247-7389 | |
| Not Available |
| Full Name | Blue Seas Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5850 Se Community Dr, Stuart, Florida |
| Authorized Official Name and Position | Diana Chiong (OWNER) |
| Authorized Official Contact | 7722477389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Seas Medical Llc Po Box 2998 Stuart FL 34995-2998 Ph: (772) 247-7389 | Blue Seas Medical Llc 5850 Se Community Dr Stuart FL 34997-6420 Ph: (772) 247-7389 |
| NPI Number | 1619462272 |
|---|---|
| Provider Enumeration Date | 06/26/2018 |
| Last Update Date | 06/26/2018 |
| Medicare PECOS PAC ID | 4082963715 |
|---|---|
| Medicare Enrollment ID | O20180814001417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619462272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS9508 (Florida) | Primary |
| Provider Name | Fernando Petry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932187747 PECOS PAC ID: 9931005253 Enrollment ID: I20050831000010 |
| Provider Name | Diana M Chiong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902884612 PECOS PAC ID: 2264451012 Enrollment ID: I20051122000253 |
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