Organization
INDIBLU MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCINDA BLUNT (EXECUTIVE DIRECTOR)
(754) 224-9333
Entity
Organization
Contact information
Practice address
1425 SW 110TH WAY, DAVIE, FL 33324-7185
(954) 445-9806
(954) 337-8265
Mailing address
1425 SW 110TH WAY, DAVIE, FL 33324-7185
(954) 445-9806
(954) 337-8265
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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