# BLUE WATER HEALTH AND WELLNESS LLC

> 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:** 1396379780
- **Authorized official:** EDWARD P SECUNDA MD (PRESIDENT)
- **Authorized official phone:** (904) 595-2583

## Contact information

- **Practice address:** 340 TOWN PLACE AVE. SUITE 240, PONTE VEDRA, FL 32081
- **Practice address phone:** (904) 595-2583
- **Practice address fax:** (904) 595-2584
- **Mailing address:** 340 TOWN PLACE AVE. SUITE 240, PONTE VEDRA, FL 32081
- **Mailing address phone:** (904) 595-2583
- **Mailing address fax:** (904) 595-2584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/25/2020
- **Last updated:** 02/25/2020