BLUE WAVE PSYCHIATRY LLC
Psychiatric at Us Highway 19, Palm Harbor, FL

License number
Florida OS11223
Category
Psychiatric
Type
Psychiatry
Owner
Name: FELIX WIDLACKI DO
Title: CEO
Phone: (727) 871-1178
Address
Address
36430 Us Highway 19 N, Palm Harbor, FL 34684
National Provider ID: 1164857876
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about BLUE WAVE PSYCHIATRY LLC at bizstanding.com

Blue Wave Psychiatry LLC

Tampa, FL  -  Palm Harbor, FL

Registration:
Jan 19, 2012
Addresses:
101 E Kennedy Blvd, Tampa, FL 33602
36430 Us Hwy 19 N, Palm Harbor, FL 34684
State ID:
L12000009222
Business type:
Florida Limited Liability
Manager:
Felix B. Widlacki (Manager)
Agent:
Erin Smith Aebel

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