Organization
BLACKSTONE MEDICAL SERVICES LLC
Active
Other names
Blackstone Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
VICK TIPNES (CEO)
(813) 831-2727
Entity
Organization
Contact information
Practice address
550 N REO ST STE 250, TAMPA, FL 33609-1039
(813) 831-2727
(888) 239-4616
Mailing address
4030 HENDERSON BLVD STE 145, TAMPA, FL 33629-4940
(813) 831-2727
(888) 239-4616
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017677000
—
FL
Enumeration date
03/16/2011
Last updated
10/03/2025
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