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Blu Haven Salon LLC — NPI 1790634566, Jacksonville, FL | NPI Central

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NPI 1790634566

OrganizationActive

Blu Haven Salon LLC

NPI 1790634566 · Prosthetic/Orthotic Supplier · Jacksonville, FL

Provider details

NPI number: 1790634566
Entity type: Organization
Primary specialty: Prosthetic/Orthotic SupplierSuppliers
Organization subpart: No
Authorized official: Guerline Divra, Owner/Manager(904) 431-2131

Specialties & taxonomies

Prosthetic/Orthotic SupplierPrimary335E00000X
Suppliers

Practice location

16259 Tisons Bluff Rd

Jacksonville, FL 32218-0141

Phone: (904) 431-2131

Approximate (ZIP-level) locationGet directions

More FL providers

Mailing address

731 Duval Station Rd

Jacksonville, FL 32218-0800

Other names (DBA / former)

Doing business as: Blu Haven Cranial Prosthetics

Registry dates

Enumerated: 2026-01-26
Last updated: 2026-01-26
Certified: 2026-01-26

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.