Organization
BLUEWATER INFUSION CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY MIXON (OWNER)
(251) 923-5537
Entity
Organization
Contact information
Practice address
921 MAR WALT DR, FORT WALTON BEACH, FL 32547-6653
(850) 388-4333
(850) 388-4338
Mailing address
921 MAR WALT DR, FORT WALTON BEACH, FL 32547-6653
(850) 388-4333
(850) 388-4338
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
08/15/2023
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