Provider Demographics
NPI:1891688461
Name:BLUEWAVE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BLUEWAVE CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VUKELICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-308-9866
Mailing Address - Street 1:1490 NE PINE ISLAND RD BUILDING 3 STE B
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909
Mailing Address - Country:US
Mailing Address - Phone:727-308-9866
Mailing Address - Fax:
Practice Address - Street 1:1490 NE PINE ISLAND RD BUILDING 3 STE B
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909
Practice Address - Country:US
Practice Address - Phone:727-308-9866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty