SURGCENTER OF ST. LUCIE LLC NPI 1053764779

NPI Information

NPI: 1053764779
Provider Name: SURGCENTER OF ST. LUCIE, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D2117203

Address:
10521 SW VILLAGE CENTER DR
SUITE 104
PORT ST LUCIE, FL
ZIP 34987
Phone: (772) 345-8600
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SURGCENTER OF ST. LUCIE, LLC is an ambulatory surgical clinic center in Port St Lucie, FL. SURGCENTER OF ST. LUCIE, LLC NPI is 1053764779. The provider is registered as an organization entity type.

The provider's business location address is:

10521 SW VILLAGE CENTER DR
SUITE 104
PORT ST LUCIE, FL
ZIP 34987-930
Phone: (772) 345-8600

The provider's authorized official is Collin Lemastrie .
The authorized official title is Officer/authorized Official and has the following contact phone number (469) 250-3640.

The CLIA number assigned to this NPI record is 10D2117203 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/18/2016 and was last updated on 9/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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