Organization
FLORIDA BLUE STAR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YUDITH SIMON APRN (ADVANCED PRACTICE REGISTERED NURSE)
(305) 803-4502
Entity
Organization
Contact information
Practice address
1325 SE 47TH ST STE I, CAPE CORAL, FL 33904-9669
(239) 205-2337
(239) 310-5287
Mailing address
1525 SE 5TH CT, CAPE CORAL, FL 33990-2019
(305) 803-4502
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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