Organization
OCEANSIDE LUXURY CARE, LLC
Active
Parent organization
HAYES MEDICAL ASSOCIATES PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAYES MEDICAL ASSOCIATES PA
Authorized official
JOHN R HAYES MD (CEO)
(772) 216-1871
Entity
Organization
Contact information
Practice address
2012 JACARANDA AVE, FORT PIERCE, FL 34949-3326
(772) 216-1871
Mailing address
2012 JACARANDA AVE, FORT PIERCE, FL 34949-3326
(772) 216-1871
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
ME46941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44200
PROVIDER NUMBER
FL
01
—
ME46941
MEDICAL LICENSE NUMBER
FL
Enumeration date
02/07/2007
Last updated
01/07/2008
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