| Blueshine Medical Center Llc | |
|
140 Santa Barbara Blvd Ste 121 Cape Coral FL 33991-2160 | |
| (305) 790-6544 | |
| Not Available |
| Full Name | Blueshine Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 140 Santa Barbara Blvd Ste 121, Cape Coral, Florida |
| Authorized Official Name and Position | Jose Gustavo Cevallos (PROVIDER) |
| Authorized Official Contact | 3057906544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blueshine Medical Center Llc 205 Nw 15th Pl Cape Coral FL 33993-7747 Ph: (561) 762-1660 | Blueshine Medical Center Llc 140 Santa Barbara Blvd Ste 121 Cape Coral FL 33991-2160 Ph: (305) 790-6544 |
| NPI Number | 1053138099 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 09/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053138099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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