# PHYSICIANS IMMEDIATE CARE ST LUCIE WEST, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHYSICIANS IMMEDIATE CARE, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699160952
- **Legal business name:** PHYSICIANS IMMEDIATE CARE, INC
- **Authorized official:** KENNETH PALESTRANT M.D. (CEO)
- **Authorized official phone:** (772) 343-1776

## Contact information

- **Practice address:** 1730 SW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-2504
- **Practice address phone:** (772) 873-8155
- **Practice address fax:** (772) 873-8858
- **Mailing address:** 1730 SW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-2504
- **Mailing address phone:** (772) 873-8155
- **Mailing address fax:** (772) 873-8858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | HCC8077 | FL | Yes |

## Other

- **Enumeration date:** 04/03/2015
- **Last updated:** 04/07/2015