BLU HAVEN SALON LLC – NPI #1790634566
Prosthetic/Orthotic Supplier

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

Health Care Provider Taxonomy Code for Prosthetic/Orthotic Supplier

BLU HAVEN SALON LLC is a DME Supplier located in JACKSONVILLE, FL. NPPES has assigned the NPI number 1790634566 to BLU HAVEN SALON LLC on January 26, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 335E00000X from the Health Care Provider Taxonomy code set, which is classified as Prosthetic/Orthotic Supplier.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLU HAVEN SALON LLC below.

NPI Profile for
BLU HAVEN SALON LLC

NPI Number
1790634566
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLU HAVEN SALON LLC
Primary location
16259 TISONS BLUFF RD
JACKSONVILLE, FL 32218-0141
Phone: (904) 431-2131 Fax:
Mailing address
731 DUVAL STATION RD
JACKSONVILLE, FL 32218-0800
Phone: (904) 431-2131 Fax:
Organization Subpart
No
Authorized Official
GUERLINE DIVRA
OWNER/MANAGER
Phone: (904) 431-2131
Updated
Certification Date
Jan 26, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
335E00000X
- Prosthetic/Orthotic Supplier (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.