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Organization
ST. LUCIE SURGICAL CENTER, P.A.
Active
Organization
ST. LUCIE SURGICAL CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANJANAYA PRASAD KORLIPARA M.D. (PRESIDENT)
(772) 429-5201
Entity
Organization
Contact information
Practice address
1300 N LAWNWOOD CIR, FORT PIERCE, FL 34950-4884
(772) 429-5201
(772) 429-5204
Mailing address
1300 N LAWNWOOD CIR, FORT PIERCE, FL 34950-4884
(772) 429-5201
(772) 429-5204
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070735000
—
FL
Enumeration date
12/16/2005
Last updated
02/20/2012
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