BLUEWATER ORTHOPEDICS, P.A. (NPI# 1700119443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700119443 |
| Entity Type | Organization |
| Organization Name | BLUEWATER ORTHOPEDICS, P.A. |
| Other Organization Name | BLUEWATER ORTHOPEDICS AND REHABILITATION |
| Practice Address |
120 E Redstone Ave Suite B Crestview FL 32539-5370 |
| Mailing Address |
1950 Bluewater Blvd Ste 100 Niceville FL 32578-3888 |
| Practice Telephone | 8503988600 |
| Practice Fax Number | 8508971520 |
| Mailing Telephone | 8508978081 |
| Mailing Fax Number | 8508971520 |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2017-03-02 |
| Authorized Official Name | MR. THOMAS FOX (PRESIDENT) |
| Authorized Official Telephone | 8508978081 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 601421 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 250939303 | 05 |
| Other Name | Type Code |
|---|---|
| Bluewater Orthopedics and Rehabilitation | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699719161 | Bluewater Orthopedics, P.a. | Orthopaedic Surgery | 1950 Bluewater Blvd, Suite 100, Niceville, FL 32578-3887 | 2006-06-15 |
| 1912941394 | Bluewater Orthopedics, P.a. | Orthopaedic Surgery | 1950 Bluewater Blvd, Suite 100, Niceville, FL 32578-3887 | 2006-06-15 |
| 1427098292 | Bluewater Orthopedics, P.a. | Physician Assistant | 1950 Bluewater Blvd, Suite 100, Niceville, FL 32578-3887 | 2006-06-08 |
| Street Address |
120 E REDSTONE AVE SUITE B |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32539-5370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770763179 | Creative Orthotic & Prosthetic Services | Durable Medical Equipment & Medical Supplies | 120 E Redstone Ave, # C, Crestview, FL 32539-5370 | 2007-11-14 |
| 1760936827 | Neil Patel | Podiatrist | 120 E Redstone Ave, Ste A, Crestview, FL 32539 | 2016-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326418336 | Abc Pediatrics of Okaloosa | Pediatrics | 182 E. Redstone Ave, Suite B, Crestview, FL 32539 | 2015-10-02 |
| 1336498443 | Jessica Carolina Carroll | Counselor | 259 E. Oakdale Ave, Crestview, FL 32539 | 2012-09-05 |
| 1902167166 | Patricia Guess | Registered Nurse | 6011 Aubrey Lee Ln, Crestview, FL 32539 | 2012-06-05 |
| 1699048181 | Chien Nguyen | Clinical Medical Laboratory | 151 East Redstone Avenue, Crestview, FL 32539 | 2012-02-15 |
| 1043494164 | Crestview Mri | Clinic/Center | 700 Hospital Drive, Crestview, FL 32539 | 2007-12-26 |
| 1558581215 | Barnes Healthcare of Fl LLC | Durable Medical Equipment & Medical Supplies | 450 Brookmeade Dr, Crestview, FL 32539 | 2007-04-26 |
| 1568576098 | Okaloosa Youth Development Center | Substance Abuse Rehabilitation Facility | 4449 Straighline Road, Crestview, FL 32539 | 2006-08-19 |
| 1154368181 | Marcello Borzatta | Surgery | 129 E. Redstone Ave, Suite A, Crestview, FL 32539 | 2006-05-31 |
| 1902850258 | Panhandle Orthopaedics LLC | Physical Therapist | 710 Hospital Drive, Crestview, FL 32539 | 2006-05-20 |
| 1619941440 | Yale R Smith | Anesthesiology | 151 Redstone Ave Se, Pinnacle Physicians LLC, Crestview, FL 32539 | 2006-02-16 |
| Find all providers in zip 32539 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811250749 | Maria Rodriguez | Specialist | 6201 Flash Ln, Crestview, FL 32536-4367 | 2012-06-15 |
| 1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
| 1831237460 | Stephen Arnold Schwartz | Specialist | 1408 Grandview Dr, Crestview, FL 32539-8519 | 2007-02-04 |
| 1932131596 | John Dale Carlson | Specialist | 492 N Wilson St, Crestview, FL 32536-3442 | 2006-07-06 |
| 1346295615 | Anesthesia and Pain Consultants, Pa | Specialist | 634 Riverwood Dr, Crestview, FL 32536-5008 | 2006-05-24 |
| 1245280858 | Shijun Pan | Specialist | 535 S Ferdon Blvd Ste C, Crestview, FL 32536-4446 | 2006-05-12 |
| 1770572745 | Alfred Cardet | Specialist | 550 W Redstone Ave, Suite300, Crestview, FL 32536-6429 | 2005-10-20 |
| 1649262650 | Marty P Gagliardi | Specialist | 127 E Redstone Ave, Suite B, Crestview, FL 32539-5358 | 2005-08-16 |
| 1063680528 | Okaloosa Pulmonary & Sleep Medicine Clinic | Specialist | 131 E Redstone Ave, Suite 105, Crestview, FL 32539-5326 | 2008-02-18 |
| 1245438704 | Charles Sedillo Mata | Specialist | 4100 S Ferdon Blvd, B-4, Crestview, FL 32536-5252 | 2007-07-06 |
| Find all providers in CRESTVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.