Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blue Wave Psychiatry LLC

Organization Psychiatry Physician · NPI 1164857876

Blue Wave Psychiatry LLC is a Psychiatry Physician in Tampa, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6601 Memorial Hwy
Tampa, FL 33615-4501
Phone: (727) 871-1178
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence OS11223 (FL)

Record details

NPI number1164857876
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Felix Widlacki — Ceo · (727) 871-1178
NPI enumeratedSeptember 12, 2013
Last updated in NPPESSeptember 1, 2020
Certification dateSeptember 1, 2020
Mailing address6601 Memorial Hwy, Tampa, FL 33615-4501

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