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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