# FLORIDA BLUE STAR INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053993550
- **Authorized official:** YUDITH SIMON APRN (ADVANCED PRACTICE REGISTERED NURSE)
- **Authorized official phone:** (305) 803-4502

## Contact information

- **Practice address:** 1325 SE 47TH ST STE I, CAPE CORAL, FL 33904-9669
- **Practice address phone:** (239) 205-2337
- **Practice address fax:** (239) 310-5287
- **Mailing address:** 1525 SE 5TH CT, CAPE CORAL, FL 33990-2019
- **Mailing address phone:** (305) 803-4502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/23/2021
- **Last updated:** 04/23/2021