ST. LUCIE SURGICAL CENTER P.A. NPI 1790761393

NPI Information

ST. LUCIE SURGICAL CENTER, P.A. is an ambulatory surgical clinic center in Fort Pierce, FL. ST. LUCIE SURGICAL CENTER, P.A. NPI is 1790761393. The provider is registered as an organization entity type.

The provider's business location address is:

1300 N LAWNWOOD CIR
FORT PIERCE, FL
ZIP 34950-884
Phone: (772) 429-5201
Fax: (772) 429-5204

The provider's authorized official is Anjanaya Prasad Korlipara .
The authorized official title is President and has the following contact phone number (772) 429-5201.

The CLIA number assigned to this NPI record is 10D0977289 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2005 and was last updated on 2/20/2012.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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