Provider Demographics
NPI:1598345597
Name:SEGURA, BLAIN (DC, MAT, ATC)
Entity type:Individual
Prefix:
First Name:BLAIN
Middle Name:
Last Name:SEGURA
Suffix:
Gender:M
Credentials:DC, MAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NW FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-1004
Mailing Address - Country:US
Mailing Address - Phone:772-780-3037
Mailing Address - Fax:
Practice Address - Street 1:1300 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-1004
Practice Address - Country:US
Practice Address - Phone:772-780-3037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15681111N00000X
FLAL66482255A2300X
AL66482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Yes111N00000XChiropractic ProvidersChiropractor