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Organization
BLUEWATER PLASTIC SURGERY & COSMETIC CENTER
Active
Organization
BLUEWATER PLASTIC SURGERY & COSMETIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN J. CLARK M.D. (PRESIDENT)
(850) 682-5332
Entity
Organization
Contact information
Practice address
4400 E HIGHWAY 20 STE 501, NICEVILLE, NICEVILLE, FL 32578-8825
(850) 682-5332
(850) 683-5333
Mailing address
4400 E HIGHWAY 20 STE 501, NICEVILLE, NICEVILLE, FL 32578-8825
(850) 682-5332
(850) 683-5333
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
ME72670
FL
Other
Enumeration date
09/28/2006
Last updated
08/22/2020
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