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Organization
SURGICAL SPECIALISTS OF ST LUCIE
Active
Organization
SURGICAL SPECIALISTS OF ST LUCIE
Active
Other names
Blue Water Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN LICHT (MANAGING DIRECTOR)
(954) 906-9536
Entity
Organization
Contact information
Practice address
6830 S US HIGHWAY 1, PORT ST LUCIE, FL 34952-1410
(772) 873-6700
(772) 465-5499
Mailing address
12350 NW 39TH ST STE 200, CORAL SPRINGS, FL 33065-2414
(954) 248-3422
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1570
FL
Other
Enumeration date
07/08/2011
Last updated
06/16/2023
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