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Organization

BLUE CLINICAL CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEXANDRA CODECIDO (OWNER)
(786) 663-2822
Entity
Organization

Contact information

Practice address
6300 CORPORATE CT, FORT MYERS, FL 33919-3513
(786) 803-8517
Mailing address
6300 CORPORATE CT, FORT MYERS, FL 33919-3513

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
09/20/2024
Last updated
09/20/2024
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