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Organization

PRIMARY CARE OF THE TREASURE COAST, INC.

Active
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Organization

PRIMARY CARE OF THE TREASURE COAST, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JACK M LUTON MBA (CHIEF EXECUTIVE OFFICER)
(772) 567-6340
Entity
Organization

Contact information

Practice address
1265 36TH ST, VERO BEACH, FL 32960-6574
(772) 567-6340
(772) 567-6788
Mailing address
1265 36TH ST, VERO BEACH, FL 32960-6574
(772) 567-6340
(772) 567-6788

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375002700
—
FL
Enumeration date
10/03/2006
Last updated
11/10/2009
About Stedi
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