| Organization Name: | BLUESTONE PHYSICIAN SERVICES FLORIDA LLC |
| NPI Number: | 1346212370 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANA BERNARD (OFFICE MANAGER) |
| Mailing Address: | 300 S Hyde Park Ave Ste 210 Tampa |
| State: | FL US |
| Postal Code: | 336064125 |
| Phone Number: | 8132591013 |
| Fax Number: | 8132540396 |
| NPI Enumeration Date: | 02/03/2006 |
| NPI Last Update Date: | 08/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5374 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |