Organization
FLORIDA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL DE JESUS GAINZA MD (MEDICAL DIRECTOR)
(772) 224-2467
Entity
Organization
Contact information
Practice address
10616 S FEDERAL HWY, PORT ST LUCIE, FL 34952-6401
(772) 224-2467
Mailing address
10616 S FEDERAL HWY, PORT ST LUCIE, FL 34952-6401
(772) 224-2467
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME86679
FL
Other
Enumeration date
03/22/2010
Last updated
03/22/2010
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