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St. Lucie Surgical Center, P.A.

Clinic/Center, Ambulatory Surgical in Fort Pierce, FL. Organization (NPI-2).

NPI number1790761393
StatusActive
Last updated in NPPESFeb 20, 2012

Details

NPI
1790761393
Entity type
Organization (NPI-2)
Legal business name
St. Lucie Surgical Center, P.A.
Organization subpart
No
Enumeration date
Dec 16, 2005
Last updated
Feb 20, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QA1903X Clinic/Center, Ambulatory Surgical1107FLYes

Practice location

1300 N Lawnwood Cir
Fort Pierce, FL 34950-4884

Phone 772-429-5201 · Fax 772-429-5204

Mailing address

1300 N Lawnwood Cir
Fort Pierce, FL 34950-4884

Phone 772-429-5201 · Fax 772-429-5204

Authorized official

Anjanaya Prasad Korlipara
President
7724295201

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