| NPI | 1255945739 |
|---|---|
| Former Legal Business Name | BLUESTONE PHYSICIAN SERVICES FLORIDA, LLC |
| Entity Type | Organization |
| Authorized Contact | TIM KOEHLER COO 651-342-1039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-10-22 |