Provider Demographics
NPI:1366108524
Name:BLUE OCEAN CLINICAL RESEARCH, LLC
Entity type:Organization
Organization Name:BLUE OCEAN CLINICAL RESEARCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, VIP FLORIDA
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-789-8770
Mailing Address - Street 1:3280 N MCMULLEN BOOTH RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2046
Mailing Address - Country:US
Mailing Address - Phone:727-789-8770
Mailing Address - Fax:727-789-8784
Practice Address - Street 1:3280 N MCMULLEN BOOTH RD STE 120
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2046
Practice Address - Country:US
Practice Address - Phone:727-789-8770
Practice Address - Fax:727-789-8784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch