# PORT ST LUCIE MEDICAL WELLNESS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821821067
- **Authorized official:** DR. HARSHA SETTY MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (813) 629-6203

## Contact information

- **Practice address:** 702 SW PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34953-2617
- **Practice address phone:** (772) 207-0080
- **Mailing address:** 702 SW PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34953-2617
- **Mailing address phone:** (772) 207-0080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2024
- **Last updated:** 08/22/2024