BLUE TIDE THERAPY
NPI 1114654431
Clinic/Center in Destin, FL

Q: What is Blue Tide Pediatric Therapy LLC's NPI number?

The NPI number for Blue Tide Pediatric Therapy LLC is 1114654431. It was assigned to this organization in the NPPES registry on August 5, 2022. The provider is doing business as Blue Tide Therapy.

Q: What is Blue Tide Pediatric Therapy LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since August 05, 2022

4641 GULFSTARR DR STE 102, DESTIN, FL 32541(850) 964-6162(850) 848-6643 Get Directions Write a Review

NPPES record last updated: January 13, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Blue Tide Therapy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE TIDE THERAPY (NPI 1114654431) is a healthcare organization registered as a clinic/center in Destin, Florida and active in the NPI registry since August 2022. The organization lists Garrett Outland, Owner/speech-language Pathologist, as its authorized official.

NPPES Registry Identity

NPI1114654431

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameBLUE TIDE PEDIATRIC THERAPY LLC

Location Address4641 GULFSTARR DR STE 102Destin, FL 32541-3776

Mailing Address4641 Gulfstarr Dr Ste 102Destin, FL 32541-3776

Phone(850) 964-6162

Fax(850) 848-6643

Organization SubpartNo

Authorized OfficialGarrett OutlandOwner/speech-language Pathologist · (850) 964-6162

Enumeration DateAugust 5, 2022

Last NPPES UpdateJanuary 13, 2025

NPPES CertifiedJanuary 13, 2025

✔ NPI 1114654431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

Also ListedMassage TherapistTaxonomy 225700000X

Also ListedSpeech-Language PathologistTaxonomy 235Z00000X

4641 GULFSTARR DR STE 102, Destin, FL 32541

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Other Names 1

Doing Business AsBlue Tide Therapy

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Tide Pediatric Therapy LLC's NPI number?

The NPI number for Blue Tide Pediatric Therapy LLC is 1114654431. It was assigned to this organization in the NPPES registry on August 5, 2022. The provider is doing business as Blue Tide Therapy.

Where is Blue Tide Pediatric Therapy LLC located?

Blue Tide Pediatric Therapy LLC is located at 4641 Gulfstarr Dr Ste 102, Destin, FL 32541. The listed phone number is (850) 964-6162.

What is Blue Tide Pediatric Therapy LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Blue Tide Pediatric Therapy LLC was last updated on January 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.