LUCILLE A VANDEVERE LLC NPI 1649466384

NPI Information

NPI: 1649466384
Provider Name: LUCILLE A VANDEVERE, LLC

Doing Business As: HEALTHCARE SERVICES

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
6989 HANCOCK DR
PORT ST LUCIE, FL
ZIP 34952
Phone: (772) 252-4130
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LUCILLE A VANDEVERE, LLC is a health service clinic center in Port St Lucie, FL. LUCILLE A VANDEVERE, LLC NPI is 1649466384. The provider is registered as an organization entity type.
The provider Is Doing Business As Healthcare Services.

The provider's business location address is:

6989 HANCOCK DR
PORT ST LUCIE, FL
ZIP 34952-207
Phone: (772) 252-4130
Fax: (772) 672-4089

The provider's authorized official is Lucille Ann Vandevere .
The authorized official title is Nurse Practitioner and has the following contact phone number (772) 252-4130.

The CLIA number assigned to this NPI record is 10D2172217 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/17/2007 and was last updated on 3/27/2018.

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	261QH0100X	Clinic/Center	Health Service	ARNP3283142	FLORIDA	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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