Organization
SAINT LUCIE PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAUL RODRIGUEZ-TORRES M.D. (CEO)
(772) 460-8235
Entity
Organization
Contact information
Practice address
2011 S 25TH ST STE 105, FORT PIERCE, FL 34947-4795
(772) 460-8235
Mailing address
2011 S 25TH ST STE 105, FORT PIERCE, FL 34947-4795
(772) 460-8235
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME54098
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049315501
—
FL
Enumeration date
11/01/2006
Last updated
06/18/2008
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