Organization
SAINT LUCIE PEDIATRICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA RODRIGUEZ (OFF MGR)
(772) 571-1533
Entity
Organization
Contact information
Practice address
32 N BROADWAY ST, FELLSMERE, FL 32948-6601
(772) 571-1533
(772) 571-8081
Mailing address
2011 S 25TH ST, 105, FORT PIERCE, FL 34947-4753
(772) 571-1533
(772) 571-8081
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2634562001
—
FL
Enumeration date
06/05/2008
Last updated
06/05/2008
Update your record
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